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

• 成果类型: Article
• 署名作者: Rubli, Adrian
• 署名单位: Instituto Tecnologico Autonomo de Mexico
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2023.104938
• 发表日期: 2023
• 关键词: primary care; Retail clinics; Provider choice; quality of care; Prescribing behavior

摘要

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 introduc-tion 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 res-piratory 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.& COPY; 2023 Elsevier B.V. All rights reserved.