Title: The Impact of a Pay-for-Performance Scheme on Prescription Quality in Rural China: An Impact Evaluation
Abstract: No AccessPolicy Research Working Papers5 Aug 2014The Impact of a Pay-for-Performance Scheme on Prescription Quality in Rural China: An Impact EvaluationAuthors/Editors: Xiaojie Sun, Xiaoyun Liu, Qiang Sun, Winnie Yip, Adam Wagstaff, Qingyue MengXiaojie Sun, Xiaoyun Liu, Qiang Sun, Winnie Yip, Adam Wagstaff, Qingyue Menghttps://doi.org/10.1596/1813-9450-6892SectionsAboutPDF (1 MB) ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookTwitterLinked In 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. Previous bookNext book FiguresreferencesRecommendeddetailsCited byIs the evidence on the effectiveness of pay for performance schemes in healthcare changing? Evidence from a meta-regression analysisBMC Health Services Research, Vol.21, No.124 February 2021Financial strategies targeting healthcare providers to promote the prudent use of antibiotics: a systematic review of the evidenceInternational Journal of Antimicrobial Agents, Vol.58, No.6Do Incentives Crowd Out Motivation? A Feasibility Study of a Community Vector-Control Campaign in PeruBehavioral Medicine, Vol.2630 November 2021In Appreciation of Adam: Reflections from Friends and ColleaguesHealth Systems & Reform, Vol.7, No.223 September 2021Primary health care financing interventions: a systematic review and stakeholder-driven research agenda for the Asia-Pacific regionBMJ Global Health, Vol.4, No.Suppl 816 August 2019Financial Incentives to Encourage Value-Based Health CareMedical Care Research and Review, Vol.75, No.14 November 2016Impacts of a new insurance benefit with capitated provider payment on healthcare utilization, expenditure and quality of medication prescribing in ChinaTropical Medicine & International Health, Vol.21, No.21 December 2015 View Published: May 2014 Copyright & Permissions Related RegionsEast Asia & PacificRelated CountriesChinaRelated TopicsHealth Nutrition and PopulationLaw and Development KeywordsPAY-FOR-PERFORMANCEDRUG PRESCRIBING PDF DownloadLoading ...