Publication: Randomized Regulation: The Impact of Minimum Quality Standards on Health Markets
Date
2023-04-04
ISSN
Published
2023-04-04
Author(s)
Bedoya, Guadalupe
Das, Jishnu
Dolinger, Any
Abstract
This paper presents results from the
first randomization of a regulatory reform in the health
sector. The reform established minimum quality standards for
patient safety, an issue that has become increasingly
salient following the Ebola and COVID-19 epidemics. In the
experiment, all 1,348 health facilities in three Kenyan
counties were classified into 273 markets, and the markets
were then randomly allocated to treatment and control
groups. Government inspectors visited health facilities and,
depending on the results of their inspection, recommended
closure or a timeline for improvements. The intervention
increased compliance with patient safety measures in both
public and private facilities (more so in the latter) and
reallocated patients from private to public facilities
without increasing out-of-pocket payments or decreasing
facility use. In treated markets, improvements were equally
marked throughout the quality distribution, consistent with
a simple model of vertical differentiation in oligopolies.
This paper thus establishes the use of experimental
techniques to study regulatory reforms and, in doing so,
shows that minimum standards can improve quality across the
board without adversely affecting utilization.
Citation
“Bedoya, Guadalupe; Das, Jishnu; Dolinger, Any. 2023. Randomized Regulation: The Impact of Minimum Quality Standards on Health Markets. Policy Research Working Papers; 10386. © World Bank, Washington, DC. http://hdl.handle.net/10986/39630 License: CC BY 3.0 IGO.”