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An Ounce of Prevention for a Pound of Cure: Efficiency of Community-Based Healthcare

Author

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  • Bancalari, Antonella

    (Institute for Fiscal Studies, London)

  • Bernal, Pedro

    (Inter-American Development Bank)

  • Celhay, Pablo

    (Pontificia Universidad Catolica de Chile)

  • Martinez, Sebastian

    (International Initiative for Impact Evaluation (3ie))

  • Sánchez, Maria Deni

    (Inter-American Development Bank)

Abstract

We study the efficiency in health systems generated by community health teams, a common strategy in low- and middle-income countries for primary healthcare delivery. We exploit the rollout of a nation-wide expansion of coverage to this model in El Salvador. Using a panel dataset of municipalities spanning 2009-2018 from consultation and hospital records of almost 4 million episodes, we show that investing in community-based healthcare, which relied on less-specialized health workers, led to a more efficient allocation of care. Preventive care increased and curative care and hospitalizations from preventable conditions decreased, while coverage in curative care for previously unattended chronic diseases increased.

Suggested Citation

  • Bancalari, Antonella & Bernal, Pedro & Celhay, Pablo & Martinez, Sebastian & Sánchez, Maria Deni, 2023. "An Ounce of Prevention for a Pound of Cure: Efficiency of Community-Based Healthcare," IZA Discussion Papers 16350, Institute of Labor Economics (IZA).
    • Handle: RePEc:iza:izadps:dp16350
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    3. Bancalari, Antonella & Berlinski, Samuel & Buitrago, Giancarlo & García, María Fernanda & de la Mata, Dolores & Vera-Hernandez, Marcos, 2023. "Health inequalities in Latin American and the Caribbean: child, adolescent, reproductive, metabolic syndrome and mental health," LSE Research Online Documents on Economics 120559, London School of Economics and Political Science, LSE Library.

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    Keywords

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    JEL classification:

    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H21 - Public Economics - - Taxation, Subsidies, and Revenue - - - Efficiency; Optimal Taxation
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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