Goldberg, Macis, and Chintagunta find that existing patients were “able and willing” to identify and bring in suspected TB patients for testing. The 3,176 patients in various treatment groups produced 222 new suspected patients, 176 of whom had symptoms and were sent for testing, and 36 of whom were diagnosed with the disease. Patients offered a financial incentive of 150 rupees, about $3, were more likely to make a referral than those who were only encouraged to do so. Offering higher payouts for referrals that resulted in a TB diagnosis did not have a significant effect compared with incentives or encouragement that did not include this condition.
Outreach by current patients resulted in more than twice as many potential patients being screened and tested than outreach by health workers. Peers, the researchers suggest, may be “more effective in conveying information about the benefits of treatment.” And peer outreach brought in patients who had fewer social connections, according to the researchers’ measure, than those identified by health workers.
The results suggest that coupling peer outreach and financial incentives can not only yield better results but also be cheaper. Identifying patients via peer referral cost 25–35 percent as much as identification via health-worker outreach.
“Because of the effectiveness of small financial incentives and the comparatively lower cost of time for current patients than health workers, incentivized peer outreach in TB detection is highly cost-effective,” the researchers write.