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

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dc.creatorSun, Xiaojie
dc.creatorLiu, Xiaoyun
dc.creatorSun, Qiang
dc.creatorYip, Winnie
dc.creatorWagstaff, Adam
dc.creatorMeng, Qingyue
dc.date2014-06-26T21:18:52Z
dc.date2014-06-26T21:18:52Z
dc.date2014-05
dc.date.accessioned2026-07-01T00:54:20Z
dc.descriptionIn 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.
dc.formatapplication/pdf
dc.formattext/plain
dc.identifierhttp://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
dc.identifierhttps://hdl.handle.net/10986/18794
dc.identifierhttps://doi.org/10.1596/1813-9450-6892
dc.identifier.urihttp://hdl.handle.net/123456789/412744
dc.languageEnglish
dc.languageen_US
dc.publisherWorld Bank, Washington, DC
dc.relationPolicy Research Working Paper;No. 6892
dc.rightsCC BY 3.0 IGO
dc.rightshttp://creativecommons.org/licenses/by/3.0/igo/
dc.subjectANTENATAL CARE
dc.subjectCAPITATION
dc.subjectCENTER FOR HEALTH
dc.subjectCHILD HEALTH
dc.subjectCHILD HEALTH SERVICES
dc.subjectCHRONIC ILLNESSES
dc.subjectCITIES
dc.subjectCLINICAL PATHWAYS
dc.subjectCLINICS
dc.subjectDEVELOPMENT POLICY
dc.subjectDIAGNOSIS
dc.subjectDOCTORS
dc.subjectDRUG RESISTANCE
dc.subjectEARLY YEARS
dc.subjectESSENTIAL DRUGS
dc.subjectFAMILIES
dc.subjectFEE-FOR-SERVICE
dc.subjectHEALTH CARE
dc.subjectHEALTH CARE FACILITIES
dc.subjectHEALTH CARE PROVIDER
dc.subjectHEALTH CARE PROVIDERS
dc.subjectHEALTH CENTERS
dc.subjectHEALTH CLINICS
dc.subjectHEALTH COVERAGE
dc.subjectHEALTH ECONOMICS
dc.subjectHEALTH INSURANCE
dc.subjectHEALTH INTERVENTIONS
dc.subjectHEALTH MANAGEMENT
dc.subjectHEALTH ORGANIZATION
dc.subjectHEALTH POLICY
dc.subjectHEALTH SERVICES
dc.subjectHEALTH SYSTEM
dc.subjectHEALTH SYSTEMS
dc.subjectHEALTH-CARE PROVIDERS
dc.subjectHEALTHCARE
dc.subjectHEALTHCARE PROVIDERS
dc.subjectHOSPITAL
dc.subjectHOSPITAL MANAGEMENT
dc.subjectHOSPITALS
dc.subjectHUMAN DEVELOPMENT
dc.subjectHYGIENE
dc.subjectILLNESS
dc.subjectIMMUNIZATION
dc.subjectINCOME
dc.subjectINSURANCE
dc.subjectINSURANCE COVERAGE
dc.subjectINSURANCE SCHEMES
dc.subjectINTERVENTION
dc.subjectLOCAL GOVERNMENTS
dc.subjectMATERNAL AND CHILD HEALTH
dc.subjectMEDICAL COLLEGE
dc.subjectMEDICAL STAFF
dc.subjectMEDICINE
dc.subjectMEDICINES
dc.subjectMIGRANT
dc.subjectMIGRANT WORKERS
dc.subjectMINISTRY OF HEALTH
dc.subjectMISUNDERSTANDING
dc.subjectNEGATIVE EFFECTS
dc.subjectNUMBER OF PEOPLE
dc.subjectOUTPATIENT SERVICES
dc.subjectPATIENT
dc.subjectPATIENT SATISFACTION
dc.subjectPATIENTS
dc.subjectPHYSICAL ENVIRONMENT
dc.subjectPHYSICIANS
dc.subjectPOLICY ANALYSIS
dc.subjectPOLICY DISCUSSIONS
dc.subjectPOLICY GOALS
dc.subjectPOLICY MAKERS
dc.subjectPOLICY RESEARCH
dc.subjectPOLICY RESEARCH WORKING PAPER
dc.subjectPOPULATION SIZE
dc.subjectPRESCRIPTIONS
dc.subjectPREVENTIVE CARE
dc.subjectPRIMARY CARE
dc.subjectPRIMARY HEALTH CARE
dc.subjectPRIMARY HEALTH CARE FACILITIES
dc.subjectPRIMARY HEALTH-CARE
dc.subjectPROGRESS
dc.subjectPROVIDER PAYMENT
dc.subjectPROVISION OF CARE
dc.subjectPUBLIC POLICY
dc.subjectPUBLIC SERVICES
dc.subjectQUALITY OF CARE
dc.subjectRURAL HOSPITALS
dc.subjectRURAL POPULATION
dc.subjectRURAL RESIDENTS
dc.subjectSERVICE PROVIDERS
dc.subjectSOCIAL HEALTH INSURANCE
dc.subjectSOCIAL SCIENCE
dc.subjectTECHNICAL SKILLS
dc.subjectTREATMENT
dc.subjectVISITS
dc.subjectWAR
dc.subjectWORKERS
dc.subjectWORLD HEALTH ORGANIZATION
dc.titleThe Impact of a Pay-for-Performance Scheme on Prescription Quality in Rural China : Impact Evaluation

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