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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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    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. Wagner, Zachary & Asiimwe, John Bosco & Levine, David I., 2020. "When financial incentives backfire: Evidence from a community health worker experiment in Uganda," Journal of Development Economics, Elsevier, vol. 144(C).
    3. Clément de Chaisemartin & Xavier D'Haultfœuille, 2020. "Two-Way Fixed Effects Estimators with Heterogeneous Treatment Effects," American Economic Review, American Economic Association, vol. 110(9), pages 2964-2996, September.
    4. Darin Christensen & Oeindrila Dube & Johannes Haushofer & Bilal Siddiqi & Maarten Voors, 2021. "Building Resilient Health Systems: Experimental Evidence from Sierra Leone and The 2014 Ebola Outbreak," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 136(2), pages 1145-1198.
    5. Goldberg, Jessica & Macis, Mario & Chintagunta, Pradeep, 2018. "Leveraging Patients' Social Networks to Overcome Tuberculosis Underdetection: A Field Experiment in India," IZA Discussion Papers 11942, Institute of Labor Economics (IZA).
    6. Harold Alderman & Peter F. Orazem & Elizabeth M. Paterno, 2001. "School Quality, School Cost, and the Public/Private School Choices of Low-Income Households in Pakistan," Journal of Human Resources, University of Wisconsin Press, vol. 36(2), pages 304-326.
    7. Cl'ement de Chaisemartin & Xavier D'Haultfoeuille, 2020. "Difference-in-Differences Estimators of Intertemporal Treatment Effects," Papers 2007.04267, arXiv.org, revised Nov 2023.
    8. Bel Germà & Fageda Xavier & E. Mildred, 2014. "Is private production of public services cheaper than public production? A meta-regression analysis of solid waste and water services," Public administration issues, Higher School of Economics, issue 3, pages 103-140.
    9. May Sudhinaraset & Matthew Ingram & Heather Kinlaw Lofthouse & Dominic Montagu, 2013. "What Is the Role of Informal Healthcare Providers in Developing Countries? A Systematic Review," PLOS ONE, Public Library of Science, vol. 8(2), pages 1-12, February.
    10. Toshiaki Iizuka, 2007. "Experts' agency problems: evidence from the prescription drug market in Japan," RAND Journal of Economics, RAND Corporation, vol. 38(3), pages 844-862, September.
    11. Alexander, Diane & Currie, Janet & Schnell, Molly, 2019. "Check up before you check out: Retail clinics and emergency room use," Journal of Public Economics, Elsevier, vol. 178(C).
    12. Brantly Callaway & Andrew Goodman-Bacon & Pedro H. C. Sant'Anna, 2021. "Difference-in-Differences with a Continuous Treatment," Papers 2107.02637, arXiv.org, revised Jan 2024.
    13. Daniel Bennett & Che-Lun Hung & Tsai-Ling Lauderdale, 2015. "Health Care Competition and Antibiotic Use in Taiwan," Journal of Industrial Economics, Wiley Blackwell, vol. 63(2), pages 371-393, June.
    14. Martina Björkman Nyqvist & Andrea Guariso & Jakob Svensson & David Yanagizawa-Drott, 2019. "Reducing Child Mortality in the Last Mile: Experimental Evidence on Community Health Promoters in Uganda," American Economic Journal: Applied Economics, American Economic Association, vol. 11(3), pages 155-192, July.
    15. Callaway, Brantly & Sant’Anna, Pedro H.C., 2021. "Difference-in-Differences with multiple time periods," Journal of Econometrics, Elsevier, vol. 225(2), pages 200-230.
    16. Dizon-Ross, Rebecca & Dupas, Pascaline & Robinson, Jonathan, 2017. "Governance and the effectiveness of public health subsidies: Evidence from Ghana, Kenya and Uganda," Journal of Public Economics, Elsevier, vol. 156(C), pages 150-169.
    17. Jishnu Das & Alaka Holla & Aakash Mohpal & Karthik Muralidharan, 2016. "Quality and Accountability in Health Care Delivery: Audit-Study Evidence from Primary Care in India," American Economic Review, American Economic Association, vol. 106(12), pages 3765-3799, December.
    18. Jessica Cohen & Pascaline Dupas & Simone Schaner, 2015. "Price Subsidies, Diagnostic Tests, and Targeting of Malaria Treatment: Evidence from a Randomized Controlled Trial," American Economic Review, American Economic Association, vol. 105(2), pages 609-645, February.
    19. Nava Ashraf & Erica Field & Jean Lee, 2014. "Household Bargaining and Excess Fertility: An Experimental Study in Zambia," American Economic Review, American Economic Association, vol. 104(7), pages 2210-2237, July.
    20. Isaac M. Mbiti, 2016. "The Need for Accountability in Education in Developing Countries," Journal of Economic Perspectives, American Economic Association, vol. 30(3), pages 109-132, Summer.
    21. Sun, Liyang & Abraham, Sarah, 2021. "Estimating dynamic treatment effects in event studies with heterogeneous treatment effects," Journal of Econometrics, Elsevier, vol. 225(2), pages 175-199.
    22. Felix Gottschalk & Wanda Mimra & Christian Waibe, 2020. "Health Services as Credence Goods: a Field Experiment," The Economic Journal, Royal Economic Society, vol. 130(629), pages 1346-1383.
    23. Jishnu Das & Jeffrey Hammer, 2014. "Quality of Primary Care in Low-Income Countries: Facts and Economics," Annual Review of Economics, Annual Reviews, vol. 6(1), pages 525-553, August.
    24. Bayer, Patrick & Pozen, David E, 2005. "The Effectiveness of Juvenile Correctional Facilities: Public versus Private Management," Journal of Law and Economics, University of Chicago Press, vol. 48(2), pages 549-589, October.
    25. José Luis Montiel Olea & Mikkel Plagborg‐Møller, 2019. "Simultaneous confidence bands: Theory, implementation, and an application to SVARs," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 34(1), pages 1-17, January.
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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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