Click here for search results
The impact of a pay-for-performance scheme on prescription quality in rural China : an impact evaluation
 
Author:Sun, Xiaojie; Liu, Xiaoyun; Sun, Qiang; Yip, Winnie; Wagstaff, Adam; Meng, Qingyue; Collection Title:Impact Evaluation series ; no. IE 128Policy Research working paper ; no. WPS 6892
Country:China; Date Stored:2014/05/28
Document Date:2014/05/01Document Type:Policy Research Working Paper
SubTopics:Health Monitoring & Evaluation; Health Systems Development & Reform; Disease Control & Prevention; Population Policies; Health LawLanguage:English
Region:East Asia and PacificReport Number:WPS6892
Volume No:1 of 1  

Summary: 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.

Official Documents
Official, scanned versions of documents (may include signatures, etc.)
File TypeDescriptionFile Size (mb)
PDF 33 pagesOfficial version*2.31 (approx.)
TextText version**
How To Order

* The official version is derived from scanning the final, paper copy of the document and is the official,
archived version including all signatures, charts, etc.
** The text version is the OCR text of the final scanned version and is not an accurate representation of the final text.
It is provided solely to benefit users with slow connectivity.



Permanent URL for this page: http://go.worldbank.org/4DBMY7HLF0