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Management, Supervision, and Health Care: A Field Experiment

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  • Felipe A. Dunsch
  • David K. Evans
  • Ezinne Eze-Ajoku
  • Mario Macis

Abstract

We used a randomized management consulting intervention with 80 public-sector healthcare facilities in Nigeria to study the role of information, training, and supervision on the adoption of improved organizational practices. Facilities that received detailed improvement plans and nine months of implementation support—including regular visits to monitor progress and set intermediate goals related to the plans—showed large, significant short-term effects on the adoption of practices that were under the responsibility of facility staff. Facilities that received general improvement advice but no implementation support showed no change in practices. Implementation support appears crucial for improvements, especially in contexts without market incentives for the adoption of effective managerial practices.

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  • Felipe A. Dunsch & David K. Evans & Ezinne Eze-Ajoku & Mario Macis, 2017. "Management, Supervision, and Health Care: A Field Experiment," NBER Working Papers 23749, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:23749
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    1. Savin, N.E., 1984. "Multiple hypothesis testing," Handbook of Econometrics, in: Z. Griliches† & M. D. Intriligator (ed.), Handbook of Econometrics, edition 1, volume 2, chapter 14, pages 827-879, Elsevier.
    2. Jeffrey R Kling & Jeffrey B Liebman & Lawrence F Katz, 2007. "Experimental Analysis of Neighborhood Effects," Econometrica, Econometric Society, vol. 75(1), pages 83-119, January.
    3. Nicholas Bloom & Benn Eifert & Aprajit Mahajan & David McKenzie & John Roberts, 2013. "Does Management Matter? Evidence from India," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 128(1), pages 1-51.
    4. World Bank, 2016. "World Development Indicators 2016," World Bank Publications - Books, The World Bank Group, number 23969.
    5. Amitabh Chandra & Amy Finkelstein & Adam Sacarny & Chad Syverson, 2016. "Health Care Exceptionalism? Performance and Allocation in the US Health Care Sector," American Economic Review, American Economic Association, vol. 106(8), pages 2110-2144, August.
    6. Nicholas Bloom & Raffaella Sadun, 2012. "The Organization of Firms Across Countries," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(4), pages 1663-1705.
    7. Jishnu Das & Jeffrey Hammer & Kenneth Leonard, 2008. "The Quality of Medical Advice in Low-Income Countries," Journal of Economic Perspectives, American Economic Association, vol. 22(2), pages 93-114, Spring.
    8. Brian Jacob & Max Kapustin & Jens Ludwig, 2014. "Human Capital Effects of Anti-Poverty Programs: Evidence from a Randomized Housing Voucher Lottery," NBER Working Papers 20164, National Bureau of Economic Research, Inc.
    9. John A. List & Azeem M. Shaikh & Yang Xu, 2019. "Multiple hypothesis testing in experimental economics," Experimental Economics, Springer;Economic Science Association, vol. 22(4), pages 773-793, December.
    10. World Bank, 2017. "World Development Indicators 2017," World Bank Publications - Books, The World Bank Group, number 26447.
    11. Roger Newson & The ALSPAC Study Team, 2003. "Multiple-test procedures and smile plots," Stata Journal, StataCorp LP, vol. 3(2), pages 109-132, June.
    12. Yoav Benjamini & Abba M. Krieger & Daniel Yekutieli, 2006. "Adaptive linear step-up procedures that control the false discovery rate," Biometrika, Biometrika Trust, vol. 93(3), pages 491-507, September.
    13. McKenzie, David, 2012. "Beyond baseline and follow-up: The case for more T in experiments," Journal of Development Economics, Elsevier, vol. 99(2), pages 210-221.
    14. Leonard, Kenneth L., 2008. "Is patient satisfaction sensitive to changes in the quality of care? An exploitation of the Hawthorne effect," Journal of Health Economics, Elsevier, vol. 27(2), pages 444-459, March.
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    Cited by:

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    2. Daniela Scur & Raffaella Sadun & John Van Reenen & Renata Lemos & Nicholas Bloom, 2021. "The World Management Survey at 18: lessons and the way forward," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 37(2), pages 231-258.
    3. Harris, Donna & Borcan , Oana & Serra, Danila & Telli, Henry & Schettini, Bruno & Dercon, Stefan, 2024. "Proud to Belong: The Impact of Ethics Training on Police Officers in Ghana," CEPR Discussion Papers 19141, C.E.P.R. Discussion Papers.
    4. Erlyn K Macarayan & Hannah L Ratcliffe & Easmon Otupiri & Lisa R Hirschhorn & Kate Miller & Stuart R Lipsitz & Atul A Gawande & Asaf Bitton, 2019. "Facility management associated with improved primary health care outcomes in Ghana," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-19, July.
    5. Donna Harris & Oana Borcan & Danila Serra & Henry Telli & Bruno Schettini & Stefan Dercon, 2022. "Proud to belong: The impact of ethics training on police officers," CSAE Working Paper Series 2022-05, Centre for the Study of African Economies, University of Oxford.
    6. Dunsch, Felipe Alexander & Velenyi, Edit, 2019. "Job Preferences of Frontline Health Workers in Ghana - A Discrete Choice Experiment," SocArXiv bqx5k, Center for Open Science.
    7. Shamma Adeeb Alam & Bijetri Bose, 2022. "Stepping into adulthood during a recession: Did job losses during the Great Recession impact health of young adults?," Health Economics, John Wiley & Sons, Ltd., vol. 31(8), pages 1730-1751, August.
    8. Sandra G. Sosa-Rubí & Sergio Bautista-Arredondo & Carlos Chivardi-Moreno & David Contreras-Loya & Gina Hera-Fuentes & Marjorie Opuni, 2021. "Efficiency, quality, and management practices in health facilities providing outpatient HIV services in Kenya, Nigeria, Rwanda, South Africa and Zambia," Health Care Management Science, Springer, vol. 24(1), pages 41-54, March.
    9. Gauri, Varun & Jamison, Julian C. & Mazar, Nina & Ozier, Owen, 2021. "Motivating bureaucrats through social recognition: External validity—A tale of two states," Organizational Behavior and Human Decision Processes, Elsevier, vol. 163(C), pages 117-131.
    10. Gauri, Varun & Jamison, Julian C. & Mazar, Nina & Ozier, Owen, 2019. "Motivating Bureaucrats through Social Recognition: External Validity — A Tale of Two States," IZA Discussion Papers 12251, Institute of Labor Economics (IZA).

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    More about this item

    JEL classification:

    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • M10 - Business Administration and Business Economics; Marketing; Accounting; Personnel Economics - - Business Administration - - - General
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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