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The effect of a mystery shopper scheme on prescribing behavior in primary care: Results from a field experiment

Author

Listed:
  • Roland Cheo

    (Center for Economic Research, Shandong University)

  • Ge Ge

    (Department of Health Management and Health Economics, University of Oslo)

  • Geir Godager

    (Department of Health Management and Health Economics, University of Oslo
    Health Services Research Unit, Akershus University Hospital)

  • Rugang Liu

    (School of Health Policy & Management, Nanjing Medical University
    Center for Global Health, Nanjing Medical University)

  • Jian Wang

    (Dong Fureng Institute of Economic and Social Development, Wuhan University
    Center for Health Economics and Management in School of Economics and Management, Wuhan University)

  • Qiqi Wang

    (School of Economics, Xi’an University of Finance and Economics)

Abstract

Background Health care systems in many countries are characterized by limited availability of provider performance data that 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. Methods Using a randomized treatment-control design, we conducted a field experiment in primary care clinics in a Chinese city. We investigate whether informing physicians of a forthcoming mystery shopper audit influences their prescribing behavior. The intervention effects are estimated using conditional fixed-effects logistic regression. The estimated coefficients are interpreted as marginal utilities in a choice model. Results Our findings suggest that the mystery shopper intervention reduced the probability of prescribing overall. Moreover, the intervention had heterogeneous effects on different types of drugs. Conclusions This study provides new evidence suggesting that announced performance auditing of primary care providers could directly affect physician behavior even when it is not combined with pay-for-performance, or measures such as reminders, feedback or educational interventions.

Suggested Citation

  • Roland Cheo & Ge Ge & Geir Godager & Rugang Liu & Jian Wang & Qiqi Wang, 2020. "The effect of a mystery shopper scheme on prescribing behavior in primary care: Results from a field experiment," Health Economics Review, Springer, vol. 10(1), pages 1-19, December.
    • Handle: RePEc:spr:hecrev:v:10:y:2020:i:1:d:10.1186_s13561-020-00290-z
    DOI: 10.1186/s13561-020-00290-z
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    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. Jean Tirole & Roland Bénabou, 2006. "Incentives and Prosocial Behavior," American Economic Review, American Economic Association, vol. 96(5), pages 1652-1678, December.
    3. 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.
    4. Wang, Jian & Iversen , Tor & Hennig-Schmidt , Heike & Godager , Geir, 2019. "Are patient-regarding preferences stable?," HERO Online Working Paper Series 2020:2, University of Oslo, Health Economics Research Programme, revised 02 Mar 2020.
    5. Hole, Arne Risa, 2008. "Modelling heterogeneity in patients' preferences for the attributes of a general practitioner appointment," Journal of Health Economics, Elsevier, vol. 27(4), pages 1078-1094, July.
    6. Daniel McFadden, 2001. "Economic Choices," American Economic Review, American Economic Association, vol. 91(3), pages 351-378, June.
    7. Wang, Jian & Iversen, Tor & Hennig-Schmidt, Heike & Godager, Geir, 2020. "Are patient-regarding preferences stable? Evidence from a laboratory experiment with physicians and medical students from different countries," European Economic Review, Elsevier, vol. 125(C).
    8. Arne Risa Hole, 2007. "Fitting mixed logit models by using maximum simulated likelihood," Stata Journal, StataCorp LP, vol. 7(3), pages 388-401, September.
    9. Gary Chamberlain, 1980. "Analysis of Covariance with Qualitative Data," Review of Economic Studies, Oxford University Press, vol. 47(1), pages 225-238.
    10. Sara Reardon, 2014. "Antibiotic resistance sweeping developing world," Nature, Nature, vol. 509(7499), pages 141-142, May.
    11. 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.
    12. Abadie, Alberto & Athey, Susan & Imbens, Guido W. & Wooldridge, Jeffrey, 2017. "When Should You Adjust Standard Errors for Clustering?," Research Papers repec:ecl:stabus:3596, Stanford University, Graduate School of Business.
    13. 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.
    14. Reynolds, Lucy & McKee, Martin, 2009. "Factors influencing antibiotic prescribing in China: An exploratory analysis," Health Policy, Elsevier, vol. 90(1), pages 32-36, April.
    15. 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.
    16. Adams, Samantha A. & Paul, Katharina T. & Ketelaars, Corry & Robben, Paul, 2015. "The use of mystery guests by the Dutch Health Inspectorate: Results of a pilot study in long-term intramural elderly care," Health Policy, Elsevier, vol. 119(6), pages 821-830.
    17. 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.
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    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 26th October 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-10-26 12:00:03

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