Does disclosure of success rates induce patients to move to a better clinic? Evidence from In Vitro Fertilization

Yoshida, Jun (2021): Does disclosure of success rates induce patients to move to a better clinic? Evidence from In Vitro Fertilization.

Abstract

Many couples have had unsuccessful fertility treatments. In 2009, the U.K. government launched an online service to provide patients with the success rates of individual clinics. I use anonymized individual patient data between 1991 and 2016 with the instrumental variable technique to investigate whether the disclosure of success rates induces patients to move to a new clinic, resulting in improved treatment outcomes. I find four main results. (i) The disclosure increases the probability that a patient moves to a new clinic. (ii) The greater the number of treatment cycles a patient has previously had, the greater the probability of moving to a new clinic. (iii) When moving to a new clinic, a patient aged over 40 has a higher probability of getting one or more transferable embryos in one treatment cycle, while a patient aged under 39 has a low probability. (iv) Regardless of age, patients who have had five or more treatments have a higher probability of obtaining an embryo in a single treatment cycle. These results suggest that public disclosure of information can facilitate efficient matching between clinics and patients over the age of 40 who have had unsuccessful IVF attempts, resulting in higher success rates.

• Item Type: MPRA Paper
• Language: English
• Keywords: In Vitro Fertilization, Information disclosure, Patient behavior, Success rates, instrumental variable
• Subjects: D - Microeconomics > D8 - Information, Knowledge, and Uncertainty; I - Health, Education, and Welfare > I1 - Health > I12 - Health Behavior; I - Health, Education, and Welfare > I1 - Health > I18 - Government Policy ; Regulation ; Public Health

References

Einav, L., Finkelstein, A., & Williams, H. (2016). Paying on the margin for medical care: Evidence from breast cancer treatments. American Economic Journal: Economic Policy, 8(1), 52-79. Gumus, G., & Lee, J. (2012). Alternative paths to parenthood: IVF or child adoption?. Economic Inquiry, 50(3), 802-820. Lundborg, P., Plug, E., & Rasmussen, A. W. (2017). Can women have children and a career? IV evidence from IVF treatments. American Economic Review, 107(6), 1611-37. Hamilton, B. H., Jungheim, E., McManus, B., & Pantano, J. (2018). Health care access, costs, and treatment dynamics: Evidence from in vitro fertilization. American Economic Review, 108(12), 3725–77. Human Fertilisation and Embryology Authority. (2018). Fertility treatment 2014–2016 Trends and figures. https://www.hfea.gov.uk/media/2563/hfea-fertility-trends-and-figures-2017-v2.pdf Schmidt, L. (2005). Infertility insurance mandates and fertility. American Economic Review, 95(2), 204–208. Schmidt, L. (2007). Effects of infertility insurance mandates on fertility. Journal of health economics, 26(3), 431–446. Werber, C. (2018). “Women in the UK are being refused IVF when they hit 34”. https://qz.com/1441364/uk-women-are-being-refused-free-ivf-treatment-by-the-nhs-at-34/ (last accessed 18 October 2019).