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Do Health Sector Reforms Have Their Intended Impacts? The World Bank's Health VIII Project in Gansu Province, China

Author  Adam Wagstaff and Shengchao Yu
Publication Date  December 14, 2006
Full Text   Adobe Acrobat PDF (294 KB)

Adam Wagstaff, and S. Yu, “Do health sector reforms have their intended impacts? The World Bank's Health VIII Project in Gansu Province, China,” Journal of Health Economics, 2006. (forthcoming)

This paper combines differences-in-differences with propensity score matching to estimate the impacts of a health reform project in China that combined supply-side interventions aimed at improving the effectiveness and quality of care with demand-side measures aimed at expanding health insurance and providing financial support to the very poor. Data from household, village, and facility surveys suggest that the project reduced out-of-pocket spending, and the incidence of catastrophic spending and impoverishment through health expenses. Little impact is detected on the use of services, and while the evidence points to the project reducing sickness days, the evidence on health outcomes is mixed.

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