信息提供与医疗创新的需求端障碍：更年期护理中共享预约的实验证据
Information Provision and Demand-Side Barriers to Healthcare Innovation: Experimental Evidence on Shared Medical Appointments in Menopause Care
NBER Working Papers · 2026 · [{"name": "Soledad Giardili", "affiliation": []}, {"name": "Monika Heller", "affiliation": []}, {"name": "Sanjay Jain", "affiliation": []}, {"name": "Amalia R. Miller", "affiliation": []}, {"name": "Kamalini Ramdas", "affiliation": []}]
中文摘要
替代性医疗服务提供模式可能为患者和服务提供者带来益处，但其采用率往往仍然较低。我们研究简短的叙事性证言是否会改变女性参加虚拟共享医疗预约（SMA）的意愿——这是一种使用相对较少的医疗服务形式，即5至15名具有共同非紧急健康状况的患者同时与一名临床医生会面。我们利用一项预注册田野实验，以英国4,000多名45至60岁女性为研究对象，将参与者随机分配至仅查看关于更年期预约选项的标准描述性信息（对照组），或接收来自既往患者或临床医生关于SMA的证言（处理组）。证言使选择SMA的女性比例增加到两倍以上：当预约等待时间为6至8周时，对照组中有11%选择SMA，而同伴证言组为26%，临床医生证言组为24%。更短的等待时间进一步提高了采用率：当SMA等待时间缩短至一周时，各组中曾选择SMA的女性比例上升了14至19个百分点，在证言组中接近40%。处理效应在信息处理能力较强的女性中系统性地更大：这些女性具有大学教育背景、更高的基线更年期知识水平，以及更广泛的信息搜寻行为。我们的研究结果表明，女性不愿选择SMA主要是由需求侧障碍驱动的，包括对SMA的不熟悉以及对其益处的不确定性，而非对基于群体的医疗服务存在根深蒂固的反感。证言似乎足以有意义地降低这些障碍。
Abstract
Alternative care delivery models may offer benefits to patients and providers, but adoption often remains low. We study whether brief narrative testimonials shift willingness to attend virtual shared medical appointments (SMAs), a relatively little-used care format in which 5-15 patients with a shared non-urgent health condition meet simultaneously with a clinician. Using a pre-registered field experiment with over 4,000 women aged 45–60 in the UK, we randomly assigned participants to view only standard descriptive information about menopause appointment options (the control group) or to receive testimonials about SMAs from either previous patients or a clinician (treatment groups). Testimonials more than doubled the share of women choosing an SMA: when appointments were offered with a 6-8 week wait, 11% of the control group chose an SMA compared to 26% in the peer testimonials arm and 24% in the clinician testimonials arm. Shorter waiting times further increase uptake. When the SMA wait was reduced to one week, the share of women ever choosing an SMA rose by 14-19 percentage points across arms, reaching nearly 40% in the testimonial groups. Treatment effects are systematically larger among women with greater information-processing capacity: university education, higher baseline menopause knowledge, and broader information-seeking. Our findings suggest that women’s reluctance to choose SMAs is driven primarily by demand-side barriers, including unfamiliarity and uncertainty about their benefits, rather than deep-seated aversion to group-based care. Testimonials appear sufficient to meaningfully reduce these barriers.