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The effect of a mystery shopper scheme on prescriptions in primary care

Author

Listed:
  • Cheo, Roland

    (1Center for Economic Research, Shandong University, China)

  • Ge, Ge

    (Department of Health Management and Health Economics)

  • Godager, Geir

    (Department of Health Management and Health Economics)

  • Liu, Rugang

    (4Center for Health Economic Experiments and Public Policy, School of Public Health, Shandong University)

  • Wang, Qiqi

    (School of Economics, Shandong University, China)

  • Wang, Jian

    (Center for Health Economic Experiments and Public Policy, School of Public Health, Shandong University)

Abstract

Health care systems in many countries are still characterized by limited availability of provider performance data which can be used to design and implement welfare improving reforms in the health sector. We question whether a simple mystery shopper scheme can be an effective measure to improve primary care quality in such settings. Using a randomized treatment-control design, we conduct a field experiment in primary care clinics in a Chinese city. We investigate whether informing clinics in the treatment group of a forthcoming mystery shopper audit influences the physicians’ prescribing behavior. As expected, we find that antibiotic medications are prescribed to patients in the majority of cases, even though such prescribing is not in accordance with current recommendations or guidelines. While the intervention did not cause significant reduction in antibiotic prescriptions, our results show that a mystery shopper scheme reduces overall unnecessary prescribing.

Suggested Citation

  • Cheo, Roland & Ge, Ge & Godager, Geir & Liu, Rugang & Wang, Qiqi & Wang, Jian, 2018. "The effect of a mystery shopper scheme on prescriptions in primary care," HERO Online Working Paper Series 2018:1, University of Oslo, Health Economics Research Programme.
    • Handle: RePEc:hhs:oslohe:2018_001
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    References listed on IDEAS

    as
    1. Currie, Janet & Lin, Wanchuan & Zhang, Wei, 2011. "Patient knowledge and antibiotic abuse: Evidence from an audit study in China," Journal of Health Economics, Elsevier, vol. 30(5), pages 933-949.
    2. Godager, Geir & Hennig-Schmidt, Heike & Iversen, Tor, 2016. "Does performance disclosure influence physicians’ medical decisions? An experimental study," Journal of Economic Behavior & Organization, Elsevier, vol. 131(PB), pages 36-46.
    3. Katz, Ethan, 2001. "Bias in Conditional and Unconditional Fixed Effects Logit Estimation," Political Analysis, Cambridge University Press, vol. 9(4), pages 379-384, January.
    4. Jean Tirole & Roland Bénabou, 2006. "Incentives and Prosocial Behavior," American Economic Review, American Economic Association, vol. 96(5), pages 1652-1678, December.
    5. Alberto Abadie & Susan Athey & Guido W Imbens & Jeffrey M Wooldridge, 2023. "When Should You Adjust Standard Errors for Clustering?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 138(1), pages 1-35.
    6. Gary Chamberlain, 1980. "Analysis of Covariance with Qualitative Data," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 47(1), pages 225-238.
    7. Sara Reardon, 2014. "Antibiotic resistance sweeping developing world," Nature, Nature, vol. 509(7499), pages 141-142, May.
    8. Farley, Pamela J., 1986. "Theories of the price and quantity of physician services : A synthesis and critique," Journal of Health Economics, Elsevier, vol. 5(4), pages 315-333, December.
    9. Madden, J. M. & Quick, J. D. & Ross-Degnan, D. & Kafle, K. K., 1997. "Undercover careseekers: Simulated clients in the study of health provider behavior in developing countries," Social Science & Medicine, Elsevier, vol. 45(10), pages 1465-1482, November.
    10. Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), 2011. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, volume 2, number 2.
    11. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    12. Dranove, David, 2011. "Health Care Markets, Regulators, and Certifiers," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 639-690, Elsevier.
    13. Reynolds, Lucy & McKee, Martin, 2009. "Factors influencing antibiotic prescribing in China: An exploratory analysis," Health Policy, Elsevier, vol. 90(1), pages 32-36, April.
    14. Robert Evans & Alan Maynard & Alexander Preker & Uwe Reinhardt, 1994. "Health care reform," Health Economics, John Wiley & Sons, Ltd., vol. 3(6), pages 359-359, November.
    15. A. J. Culyer & J. P. Newhouse (ed.), 2000. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, edition 1, volume 1, number 1.
    16. Hui Pan & Binglin Cui & Dangui Zhang & Jeremy Farrar & Frieda Law & William Ba-Thein, 2012. "Prior Knowledge, Older Age, and Higher Allowance Are Risk Factors for Self-Medication with Antibiotics among University Students in Southern China," PLOS ONE, Public Library of Science, vol. 7(7), pages 1-8, July.
    17. Currie, Janet & Lin, Wanchuan & Meng, Juanjuan, 2014. "Addressing antibiotic abuse in China: An experimental audit study," Journal of Development Economics, Elsevier, vol. 110(C), pages 39-51.
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    More about this item

    Keywords

    Field Experiment; Analysis of Health Care Markets; Government Policy; Information and Product Quality; Social Responsibility.;
    All these keywords.

    JEL classification:

    • C93 - Mathematical and Quantitative Methods - - Design of Experiments - - - Field Experiments
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L15 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Information and Product Quality
    • M14 - Business Administration and Business Economics; Marketing; Accounting; Personnel Economics - - Business Administration - - - Corporate Culture; Diversity; Social Responsibility

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