Fostering institutional trust and organ donation: Evidence from a randomized informational intervention in Tunisia
中文摘要
器官移植能够挽救生命，并改善那些否则将依赖昂贵且具侵入性治疗的患者的生命质量。该技术在中低收入国家正逐渐可及，但器官移植的供需缺口依然巨大。我们在突尼斯一所大学开展随机对照试验，评估一项由专家主导、旨在提供器官捐献信息并增强对医疗机构信任的干预。该干预包括一段心脏移植幸存者的简短视频证言、一场由医生主讲的报告以及一次简短的问答环节。我们发现，该干预显著提高了遗体器官捐献登记率，并有提示性证据表明对对照组存在正向溢出效应。调查数据几乎不支持态度和社会期望的变化作为潜在机制。相反，它显示受处理学生的医学与法律知识、支持捐献的宗教信仰以及制度信任均出现大幅且统计显著的提升。最后，我们表明，干预对器官捐献登记的处理效应由男生以及其家庭可能支持器官捐献的学生所驱动。针对年龄较大的人群可能进一步增强该干预的影响力和成本有效性。
Abstract
Organ transplantation saves lives and improves the quality of life of patients who would otherwise depend on costly and invasive treatments. The technology is becoming available in low- and middle-income countries, but the gap between the demand for and the supply of organ transplants remains large. In a randomized controlled trial at a Tunisian university, we evaluate an expert-led intervention designed to inform about organ donation and strengthen trust in medical institutions. The intervention consists of a short video testimonial from a heart transplant survivor, a presentation led by a medical doctor and a short Q&A session. We find that the intervention significantly increases deceased donor registration, with suggestive evidence of positive spillover effects on the control group. The survey data provides little support for changes in attitudes and social expectations as potential mechanisms. Instead, it reveals large and statistically significant increases in medical and legal knowledge, religious beliefs supportive of donation, and institutional trust among treated students. Finally, we show that treatment effects on organ donor registration are driven by male students and those whose families likely support organ donation. Targeting older segments of the population may further increase the impact and cost-effectiveness of this intervention.