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Trade-offs between access and quality in healthcare: Evidence from retail clinics in Mexico

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  • Rubli, Adrian

Abstract

In settings with inefficient public provision, expansions in low-cost private-market healthcare delivery may be welfare-improving by increasing access, but may be sacrificing on quality. I study the introduction of retail clinics at private pharmacies in Mexico. I find that entry led to large declines in public-sector emergency room visits and a small but significant reduction in public clinic visits for relatively mild respiratory infections. I also find a significant increase in public clinic visits for chronic conditions and a slight decline in emergency room visits, consistent with better disease management. However, I estimate a sizable association between retail clinics and a shift toward stronger antibiotics in private-market sales. Hence, although retail clinics improve access to healthcare, they may be overselling their patients.

Suggested Citation

  • Rubli, Adrian, 2023. "Trade-offs between access and quality in healthcare: Evidence from retail clinics in Mexico," Journal of Public Economics, Elsevier, vol. 224(C).
    • Handle: RePEc:eee:pubeco:v:224:y:2023:i:c:s0047272723001202
    DOI: 10.1016/j.jpubeco.2023.104938
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    More about this item

    Keywords

    Primary care; Retail clinics; Provider choice; Quality of care; Prescribing behavior;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development

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