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The investigators conduct a large-scale randomized controlled trial in Finland by sending three types of information letters to households to examine whether the reminder letters affect healthcare use. All letters remind of the importance of seeking care to treat potential health problems.
This study has two primary objectives are: to evaluate the effects of an information nudge reminding on the importance of diagnosing and treating health problems and to evaluate the effects of additionally providing information on the fact that primary care nurse visits have become exempt from copayments. Main outcomes include the number of primary care nurse visits and general practitioner (GP) visits in a six-month follow-up.
This study has two main objectives: (i) to evaluate the effect of an information nudge reminding on the importance of diagnosing and treating health problems and (ii) to evaluate the effect of providing information on the fact that primary care nurse visits have become exempt from co-payments.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Basic letter | Active Comparator | This reminder states that if healthcare is not consumed at the right time, health may deteriorate and diagnoses and treatment may be delayed. |
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| Co-pay | Active Comparator | This reminder states that if healthcare is not consumed at the right time, health may deteriorate and diagnoses and treatment may be delayed AND informs recipients about a new law that abolished all co-payments for all primary care nurse visits in Finland. |
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| GP-Co-pay | Active Comparator | This reminder states that if healthcare is not consumed at the right time, health may deteriorate and diagnoses and treatment may be delayed AND informs recipients about a new law that abolished all co-payments for all primary care nurse visits in Finland, AND informs recipients that the new law did not abolish co-payments related to general practitioner visits. |
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| Control treatment | No Intervention | There is no intervention in the control treatment. The entire population aged 55 and above in the treatment regions will serve as a control group. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Reminder (information letter) | Other | Reminders |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of nurse visits (as recorded in the Finnish National Register of Primary Health Care Visits) | Six months starting from the date the letters are sent | |
| Number of doctor visits (as recorded in the Finnish National Register of Primary Health Care Visits) | Six months starting from the date the letters are sent |
| Measure | Description | Time Frame |
|---|---|---|
| Number of referrals to specialized care (as recorded in the Finnish National Register of Primary Health Care Visits) | Six months starting from the date the letters are sent | |
| Number of drug prescriptions for newly initiated therapies (as recorded in the Finnish national register for prescribed medicines) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Lauri Sääksvuori, PhD | Finnish Institute for Health and Welfare and University of Turku | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Finnish Institute for Health and Welfare | Helsinki | 00271 | Finland |
This paper uses administrative health records maintained by the Finnish Institute for Health and Welfare. Access to health records is regulated in Finland under the Act on the Secondary Use of Health and Social Data (552/2019). De-identified individual participant data will be shared subject to approval by the competent data protection authority. All statistical code used to organize and analyze the data will be shared.
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| ID | Term |
|---|---|
| D010342 | Patient Acceptance of Health Care |
| D015438 | Health Behavior |
| ID | Term |
|---|---|
| D000074822 | Treatment Adherence and Compliance |
| D001519 | Behavior |
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This is a randomized controlled trial with three active treatment arms and a control group (not assigned to any treatment, information and services as usual).
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This is a randomized experiment in which individuals receive different types of reminders. All outcome variables are based on administrative (secondary) data. Individuals receiving letters and care providers are not aware of the experiment. Investigators will not have any contact with the participants.
| Six months starting from the date the letters are sent |