Patient satisfaction surveys are an increasingly common element of efforts to evaluate the quality of healthcare. Many patient satisfaction surveys in low/middle-income countries frame statements positively and invite patients to agree or disagree, so that positive responses may reflect either true satisfaction or bias induced by the positive framing. In an experiment with more than 2200 patients in Nigeria, we distinguish between actual satisfaction and survey biases. Patients randomly assigned to receive negatively framed statements expressed significantly lower levels of satisfaction (87%) than patients receiving the standard positively framed statements (95%—p<0.001). Depending on the question, the effect is as high as a 19 percentage point drop (p<0.001). Thus, high reported patient satisfaction likely overstates the quality of health services. Providers and policymakers wishing to gauge the quality of care will need to avoid framing that induces bias and to complement patient satisfaction measures with more objective measures of quality.

Nicola Lacetera, Mario Macis, Angelo Mele Sociological Science, March 24, 2016 DOI 10.15195/v3.a11 Abstract How do social media affect the success of charitable campaigns? We show that, despite the promise of online platforms to generate social network effects in generosity through social contagion...

Organizations and public agencies that promote pro-social activities constantly struggle to attract and encourage more contributions. In this article, we study the effects of an explicit reward in the context of blood donation. Specifically, we analyze the effects of a legislative provision that grants a one-day paid leave of absence to blood donors who are employees in Italy, using a unique data set with the complete donation histories of the blood donors in an Italian town. The across-donor variation in employment status, and within-donor changes over time are the sources of variation that we employ to study whether the paid-day-off incentive affects the frequency of their donations. Our analysis indicates that the day-off privilege leads donors who are employees to make, on average, one extra donation per year, which represents an increase of around 40%. We also find that the provision has persistent effects, with donors maintaining higher donation frequencies even when they cease to be eligible for the incentive. We discuss the implications of our findings for policies aimed at reducing the shortages in the supply of blood and, more generally, for organizations that try to motivate voluntary contributors. (JEL: D12, D64, I18)