Increasing the take-up of public health services: An at-scale experiment on digital government

Increasing public service take-up is a critical challenge. We invested in a government-run digital appointment system for an important health screening service and conducted a large-scale experiment encouraging its use, specifically assessing the influence of transactions costs and information. Using administrative records on the near-universe of eligible women (47,600) in Uruguay's capital city, we randomized invitations to book with our digital-system or as-usual with local clinics. Digital encouragements doubled medical visits versus as-usual invitations, and tripled compared to a pure control group (5.5 % versus 1.9 %) over 16 weeks. These large impacts are highly cost-effective, mediated by salience and reduced transactions costs.