The Impact of a Pay-for-Performance Scheme on Prescription Quality in Rural China : Impact Evaluation

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collection.link.5
https://openknowledge.worldbank.org/handle/10986/9
collection.name.5
Policy Research Working Papers
dc.contributor.author
Sun, Xiaojie
dc.contributor.author
Liu, Xiaoyun
dc.contributor.author
Sun, Qiang
dc.contributor.author
Yip, Winnie
dc.contributor.author
Wagstaff, Adam
dc.contributor.author
Meng, Qingyue
dc.date.accessioned
2014-06-26T21:18:52Z
dc.date.available
2014-06-26T21:18:52Z
dc.date.issued
2014-05
dc.description.abstract
In China, health care providers have traditionally been paid fee-for-service and overprescribing and high out-of-pocket spending are common. In this study, township health centers in two counties were assigned almost randomly to two groups: in one, fee-for-service was replaced by a global capitated budget; in the other, by a mix of global capitated budget and pay-for-performance. Performance captured inter alia "irrational" drug prescribing; 20 percent of the global capitated budget was withheld each quarter, points were deducted for failure to meet targets, and some of the withheld budget was returned in line with the points deducted. Outcomes included appropriate prescribing and prescription cost, data on which were obtained by digitizing prescriptions from a month just before the reform and from the same month a year later. Impacts were assessed via multivariate differences-in-differences with township health center fixed effects. To reduce bias from non-randomness in assignment, the sample was trimmed by coarsened exact matching. Pay-for-performance reduced inappropriate prescribing significantly and substantially in the county where the initial level was above the penalty threshold, but end-line rates were still appreciable; no effects were seen in the county where initial levels were around or below the threshold, or on out-of-pocket spending in either county.
en
dc.identifier.uri
http://hdl.handle.net/10986/18794
dc.language
English
dc.language.iso
en_US
dc.publisher
World Bank, Washington, DC
dc.relation.ispartofseries
Policy Research Working Paper;No. 6892
dc.rights
CC BY 3.0 IGO
dc.rights.uri
http://creativecommons.org/licenses/by/3.0/igo/
dc.subject
ANTENATAL CARE
dc.subject
CAPITATION
dc.subject
CENTER FOR HEALTH
dc.subject
CHILD HEALTH
dc.subject
CHILD HEALTH SERVICES
dc.subject
CHRONIC ILLNESSES
dc.subject
CITIES
dc.subject
CLINICAL PATHWAYS
dc.subject
CLINICS
dc.subject
DEVELOPMENT POLICY
dc.subject
DIAGNOSIS
dc.subject
DOCTORS
dc.subject
DRUG RESISTANCE
dc.subject
EARLY YEARS
dc.subject
ESSENTIAL DRUGS
dc.subject
FAMILIES
dc.subject
FEE-FOR-SERVICE
dc.subject
HEALTH CARE
dc.subject
HEALTH CARE FACILITIES
dc.subject
HEALTH CARE PROVIDER
dc.subject
HEALTH CARE PROVIDERS
dc.subject
HEALTH CENTERS
dc.subject
HEALTH CLINICS
dc.subject
HEALTH COVERAGE
dc.subject
HEALTH ECONOMICS
dc.subject
HEALTH INSURANCE
dc.subject
HEALTH INTERVENTIONS
dc.subject
HEALTH MANAGEMENT
dc.subject
HEALTH ORGANIZATION
dc.subject
HEALTH POLICY
dc.subject
HEALTH SERVICES
dc.subject
HEALTH SYSTEM
dc.subject
HEALTH SYSTEMS
dc.subject
HEALTH-CARE PROVIDERS
dc.subject
HEALTHCARE
dc.subject
HEALTHCARE PROVIDERS
dc.subject
HOSPITAL
dc.subject
HOSPITAL MANAGEMENT
dc.subject
HOSPITALS
dc.subject
HUMAN DEVELOPMENT
dc.subject
HYGIENE
dc.subject
ILLNESS
dc.subject
IMMUNIZATION
dc.subject
INCOME
dc.subject
INSURANCE
dc.subject
INSURANCE COVERAGE
dc.subject
INSURANCE SCHEMES
dc.subject
INTERVENTION
dc.subject
LOCAL GOVERNMENTS
dc.subject
MATERNAL AND CHILD HEALTH
dc.subject
MEDICAL COLLEGE
dc.subject
MEDICAL STAFF
dc.subject
MEDICINE
dc.subject
MEDICINES
dc.subject
MIGRANT
dc.subject
MIGRANT WORKERS
dc.subject
MINISTRY OF HEALTH
dc.subject
MISUNDERSTANDING
dc.subject
NEGATIVE EFFECTS
dc.subject
NUMBER OF PEOPLE
dc.subject
OUTPATIENT SERVICES
dc.subject
PATIENT
dc.subject
PATIENT SATISFACTION
dc.subject
PATIENTS
dc.subject
PHYSICAL ENVIRONMENT
dc.subject
PHYSICIANS
dc.subject
POLICY ANALYSIS
dc.subject
POLICY DISCUSSIONS
dc.subject
POLICY GOALS
dc.subject
POLICY MAKERS
dc.subject
POLICY RESEARCH
dc.subject
POLICY RESEARCH WORKING PAPER
dc.subject
POPULATION SIZE
dc.subject
PRESCRIPTIONS
dc.subject
PREVENTIVE CARE
dc.subject
PRIMARY CARE
dc.subject
PRIMARY HEALTH CARE
dc.subject
PRIMARY HEALTH CARE FACILITIES
dc.subject
PRIMARY HEALTH-CARE
dc.subject
PROGRESS
dc.subject
PROVIDER PAYMENT
dc.subject
PROVISION OF CARE
dc.subject
PUBLIC POLICY
dc.subject
PUBLIC SERVICES
dc.subject
QUALITY OF CARE
dc.subject
RURAL HOSPITALS
dc.subject
RURAL POPULATION
dc.subject
RURAL RESIDENTS
dc.subject
SERVICE PROVIDERS
dc.subject
SOCIAL HEALTH INSURANCE
dc.subject
SOCIAL SCIENCE
dc.subject
TECHNICAL SKILLS
dc.subject
TREATMENT
dc.subject
VISITS
dc.subject
WAR
dc.subject
WORKERS
dc.subject
WORLD HEALTH ORGANIZATION
dc.title
The Impact of a Pay-for-Performance Scheme on Prescription Quality in Rural China : Impact Evaluation
en
okr.date.disclosure
2014-05-01
okr.doctype
Publications & Research :: Policy Research Working Paper
okr.doctype
Publications & Research
okr.docurl
http://documents.worldbank.org/curated/en/2014/05/19581000/impact-pay-for-performance-scheme-prescription-quality-rural-china-impact-evaluation-impact-pay-for-performance-scheme-prescription-quality-rural-china-impact-evaluation
okr.globalpractice
Health, Nutrition, and Population
okr.globalpractice
Governance
okr.globalpractice
Health, Nutrition, and Population
okr.googlescholar.linkpresent
yes
okr.identifier.doi
10.1596/1813-9450-6892
okr.identifier.externaldocumentum
000158349_20140528145050
okr.identifier.internaldocumentum
19581000
okr.identifier.report
WPS6892
okr.language.supported
en
okr.pdfurl
http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2014/05/28/000158349_20140528145050/Rendered/PDF/WPS6892.pdf
en
okr.region.administrative
East Asia and Pacific
okr.region.country
China
okr.topic
Health Monitoring and Evaluation
okr.topic
Law and Development :: Health Law
okr.topic
Health Systems Development and Reform
okr.topic
Health, Nutrition and Population :: Population Policies
okr.topic
Disease Control and Prevention
okr.unit
Human Development and Public Services Team, Development Research Group
okr.volume
1 of 1

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