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Revisit the one-time subsidies and long-run adoption of health products: Quasi-experimental evidence from providing free eyeglasses in rural China

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  • Guan, Hongyu
  • Zhang, Yunyun
  • Du, Kang
  • Wang, Zhijie
  • Shi, Yaojiang

Abstract

Promoting the adoption of health goods and services, especially in developing countries with low utilization rates, is crucial. Governments and non-governmental organizations often provide free or highly subsidized healthcare services and products. However, the long-term effects of these subsidies on the adoption of high-return technologies or products remain debated. This study, centered on children's vision care, investigates whether one-time subsidies for eyeglasses influence families' long-term private investment in purchased eyeglasses. The quasi-experiment was conducted in rural Shaanxi province, Northwest China, between January 2017 and December 2019 and involved 2,936 students from two county-level vision centers. The participants were divided into a treatment group receiving free eyeglasses (voucher group) and a control group receiving only prescription information (prescription group). Results demonstrate that providing a one-time subsidy significantly increased subsequent out-of-pocket purchases of vision health services. Notably, the fully subsidized group exhibited a 20-percentage-point higher rate of out-of-pocket eyeglass purchases compared to the control group once the subsidy was no longer provided. These positive impacts can be attributed to learning and peer effects arising from the subsidization phase. This study underscores the overall value of subsidies in boosting the uptake of underutilized health services, both in the short term and, more importantly, in the long term. Moreover, it suggests broader implications for promoting the adoption of various health products beyond vision care.

Suggested Citation

  • Guan, Hongyu & Zhang, Yunyun & Du, Kang & Wang, Zhijie & Shi, Yaojiang, 2024. "Revisit the one-time subsidies and long-run adoption of health products: Quasi-experimental evidence from providing free eyeglasses in rural China," World Development, Elsevier, vol. 179(C).
  • Handle: RePEc:eee:wdevel:v:179:y:2024:i:c:s0305750x24000974
    DOI: 10.1016/j.worlddev.2024.106627
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    1. Michael Kremer & Edward Miguel, 2007. "The Illusion of Sustainability," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(3), pages 1007-1065.
    2. Renfu Luo & Yaojiang Shi & Linxiu Zhang & Huiping Zhang & Grant Miller & Alexis Medina & Scott Rozelle, 2012. "The Limits of Health and Nutrition Education: Evidence from Three Randomized-Controlled Trials in Rural China," CESifo Economic Studies, CESifo Group, vol. 58(2), pages 385-404, June.
    3. Botond Kőszegi & Matthew Rabin, 2006. "A Model of Reference-Dependent Preferences," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 121(4), pages 1133-1165.
    4. Duflo, Esther & Dupas, Pascaline & Kremer, Michael & Sinei, Samuel, 2006. "Education and HIV/AIDS prevention : evidence from a randomized evaluation in Western Kenya," Policy Research Working Paper Series 4024, The World Bank.
    5. Marco Caliendo & Sabine Kopeinig, 2008. "Some Practical Guidance For The Implementation Of Propensity Score Matching," Journal of Economic Surveys, Wiley Blackwell, vol. 22(1), pages 31-72, February.
    6. Pascaline Dupas, 2011. "Do Teenagers Respond to HIV Risk Information? Evidence from a Field Experiment in Kenya," American Economic Journal: Applied Economics, American Economic Association, vol. 3(1), pages 1-34, January.
    7. Jin Zhao & Huan Wang & Hongyu Guan & Kang Du & Yunyun Zhang & Nathan Congdon, 2022. "Impact of Teacher Incentive Intervention on Students’ Vision Healthcare Uptake: A Cluster-Randomized Controlled Trial," IJERPH, MDPI, vol. 19(19), pages 1-14, October.
    8. Powell, Lisa M. & Tauras, John A. & Ross, Hana, 2005. "The importance of peer effects, cigarette prices and tobacco control policies for youth smoking behavior," Journal of Health Economics, Elsevier, vol. 24(5), pages 950-968, September.
    9. Fischer, Greg & Karlan, Dean & McConnell, Margaret & Raffler, Pia, 2019. "Short-term subsidies and seller type: A health products experiment in Uganda," Journal of Development Economics, Elsevier, vol. 137(C), pages 110-124.
    10. Nava Ashraf & James Berry & Jesse M. Shapiro, 2010. "Can Higher Prices Stimulate Product Use? Evidence from a Field Experiment in Zambia," American Economic Review, American Economic Association, vol. 100(5), pages 2383-2413, December.
    11. Jörg Peters & Jörg Langbein & Gareth Roberts, 2018. "Generalization in the Tropics – Development Policy, Randomized Controlled Trials, and External Validity," The World Bank Research Observer, World Bank, vol. 33(1), pages 34-64.
    12. Glewwe, Paul & Park, Albert & Zhao, Meng, 2016. "A better vision for development: Eyeglasses and academic performance in rural primary schools in China," Journal of Development Economics, Elsevier, vol. 122(C), pages 170-182.
    13. Hangoma, Peter & Robberstad, Bjarne & Aakvik, Arild, 2018. "Does Free Public Health Care Increase Utilization and Reduce Spending? Heterogeneity and Long-Term Effects," World Development, Elsevier, vol. 101(C), pages 334-350.
    14. Jingchun Nie & Xiaopeng Pang & Lei Wang & Scott Rozelle & Sean Sylvia, 2020. "Seeing Is Believing: Experimental Evidence on the Impact of Eyeglasses on Academic Performance, Aspirations, and Dropout among Junior High School Students in Rural China," Economic Development and Cultural Change, University of Chicago Press, vol. 68(2), pages 335-355.
    15. Xiaochen Ma & Huan Wang & Yaojiang Shi & Sean Sylvia & Lei Wang & Yiwei Qian & Scott Rozelle, 2021. "Improving learning by improving vision: evidence from two randomized controlled trials of providing vision care in China," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 13(1), pages 1-26, January.
    16. Michael Grimm & Renate Hartwig, 2022. "All eyes on the price: An assessment of the willingness‐to‐pay for eyeglasses in rural Burkina Faso," Health Economics, John Wiley & Sons, Ltd., vol. 31(7), pages 1347-1367, July.
    17. Douglas Staiger & James H. Stock, 1997. "Instrumental Variables Regression with Weak Instruments," Econometrica, Econometric Society, vol. 65(3), pages 557-586, May.
    18. Jessica Cohen & Pascaline Dupas, 2010. "Free Distribution or Cost-Sharing? Evidence from a Randomized Malaria Prevention Experiment," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 125(1), pages 1-45.
    19. Alberto Abadie & Guido W. Imbens, 2006. "Large Sample Properties of Matching Estimators for Average Treatment Effects," Econometrica, Econometric Society, vol. 74(1), pages 235-267, January.
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