Reminders, Cost Sharing, and Healthcare Use

Sponsor

Finnish Institute for Health and Welfare (Other)

Overall Status

Not yet recruiting

CT.gov ID

NCT05117333

Collaborator

(none)

47,398

Enrollment

Location

Arms

Anticipated Duration (Months)

3652.3

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

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.

Condition or Disease	Intervention/Treatment	Phase
Health Care Utilization Health Care Seeking Behavior Health Behavior	Other: Reminder (information letter)	N/A

Detailed Description

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.

Study Design

Study Type:

Interventional

Anticipated Enrollment :

47398 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Intervention Model Description:

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).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).

Masking:

Triple (Participant, Care Provider, Investigator)

Masking Description:

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.

Primary Purpose:

Health Services Research

Official Title:

Reminders, Cost Sharing, and Healthcare Use

Anticipated Study Start Date :

Nov 1, 2021

Anticipated Primary Completion Date :

Nov 1, 2021

Anticipated Study Completion Date :

Dec 1, 2022

Arms and Interventions

Arm	Intervention/Treatment
Active Comparator: Basic letter This reminder states that if healthcare is not consumed at the right time, health may deteriorate and diagnoses and treatment may be delayed.	Other: Reminder (information letter) Reminders
Active Comparator: Co-pay 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.	Other: Reminder (information letter) Reminders
Active Comparator: GP-Co-pay 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.	Other: Reminder (information letter) Reminders
No Intervention: Control treatment 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.

Outcome Measures

Primary Outcome Measures

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]

Secondary Outcome Measures

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) [Six months starting from the date the letters are sent]

Eligibility Criteria

Criteria

Ages Eligible for Study:

55 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Yes

Inclusion Criteria:

Residency in one of the 25 target municipalities as of September 15, 2021.
Born in 1966 or earlier (aged 55 or more at the end of 2021).
Living in a household with a maximum of three individuals aged 55 or above.

Exclusion Criteria:

Individuals living in households (postal address) with more than three individuals aged 55 and above.

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Finnish Institute for Health and Welfare	Helsinki		Finland	00271

Sponsors and Collaborators

Finnish Institute for Health and Welfare

Investigators

Principal Investigator: Lauri Sääksvuori, PhD, Finnish Institute for Health and Welfare and University of Turku

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

Responsible Party:

Lauri Sääksvuori, Associate professor, Finnish Institute for Health and Welfare

ClinicalTrials.gov Identifier:

NCT05117333

Other Study ID Numbers:

THL/3181/6.02.01/2021

First Posted:

Nov 11, 2021

Last Update Posted:

Nov 11, 2021

Last Verified:

Nov 1, 2021

Individual Participant Data (IPD) Sharing Statement:

Plan to Share IPD:

Studies a U.S. FDA-regulated Drug Product:

Studies a U.S. FDA-regulated Device Product:

Keywords provided by Lauri Sääksvuori, Associate professor, Finnish Institute for Health and Welfare

Cost-sharing, primary care, health care utilization

Study Results

No Results Posted as of Nov 11, 2021