REALIGNING DEMAND AND SUPPLY SIDE INCENTIVES TO IMPROVE PRIMARY HEALTH CARE SEEKING IN RURAL CHINA
Article first published online: 8 MAY 2014
Copyright © 2014 John Wiley & Sons, Ltd.
How to Cite
Powell-Jackson, T., Yip, W. C.-M. and Han, W. (2014), REALIGNING DEMAND AND SUPPLY SIDE INCENTIVES TO IMPROVE PRIMARY HEALTH CARE SEEKING IN RURAL CHINA. Health Econ.. doi: 10.1002/hec.3060
- Article first published online: 8 MAY 2014
- Manuscript Accepted: 2 APR 2014
- Manuscript Revised: 20 FEB 2014
- Manuscript Received: 18 JUN 2013
- Bill and Melinda Gates Foundation. Grant Number: HEALTH-F2-2009-223166-HEFPA
- impact evaluation;
- health insurance;
- capitation payment;
China's recent and ambitious health care reform involves a shift from the reliance on markets to the reaffirmation of the central role of the state in the financing and provision of services. In collaboration with the Government of the Ningxia province, we examined the impact of two key features of the reform on health care utilisation using panel household data. The first policy change was a redesign of the rural insurance benefit package, with an emphasis on reorientating incentives away from inpatient towards outpatient care. The second policy change involved a shift from a fee-for-service payment method to a capitation budget with pay-for-performance amongst primary care providers. We find that the insurance intervention, in isolation, led to a 47% increase in the use of outpatient care at village clinics and greater intensity of treatment (e.g. injections). By contrast, the two interventions in combination showed no effect on health care use over and above that generated by the redesign of the insurance benefit package. Copyright © 2014 John Wiley & Sons, Ltd.