Healthy nudges: exploring their variability, limitations, and future challenges.

Abstract

Objective: To review several behavioral economics-based interventions ("healthy nudges") aimed at mitigating the overuse and underuse of healthcare resources -phenomena associated with poorer health outcomes and increased costs.

Method: A comparative case study approach is used to assess the effectiveness of ten studies designed to improve treatment adherence and prevent underuse, as well as those focused on improving prescribing practices to address overuse.

Results: First, healthy nudges are generally effective, although there is considerable variability in their outcomes. Effectiveness compared to the control group ranges from 5% to over 30%. Second, similar strategies may yield divergent results depending on the context (e.g., medication adherence vs. vaccination uptake). Third, the effect of healthy nudges appears to diminish after the intervention ends, especially for economic incentives. However, default options seem to remain persistent over time.

Conclusions: The article examines the pros and cons of healthy nudges in the use and provision of healthcare services. The evidence gathered from the selected studies suggests that nudges may help rationalize healthcare use. However, challenges remain, such as ensuring the long-term persistence of effects and evaluating their impact on well-being and cost-effectiveness.