The effect of a mystery shopper scheme on prescribing behavior in primary care: Results from a field experiment
- PDF / 1,752,823 Bytes
- 19 Pages / 595 x 791 pts Page_size
- 4 Downloads / 185 Views
RESEARCH
Open Access
The effect of a mystery shopper scheme on prescribing behavior in primary care: Results from a field experiment Roland Cheo1 , Ge Ge2
* , Geir Godager2,3 , Rugang Liu4,5 , Jian Wang6,7
and Qiqi Wang8
Abstract Background: Health care systems in many countries are characterized by limited availability of provider performance data that can be used to design and implement welfare improving reforms in the health sector. We question whether a simple mystery shopper scheme can be an effective measure to improve primary care quality in such settings. Methods: Using a randomized treatment-control design, we conducted a field experiment in primary care clinics in a Chinese city. We investigate whether informing physicians of a forthcoming mystery shopper audit influences their prescribing behavior. The intervention effects are estimated using conditional fixed-effects logistic regression. The estimated coefficients are interpreted as marginal utilities in a choice model. Results: Our findings suggest that the mystery shopper intervention reduced the probability of prescribing overall. Moreover, the intervention had heterogeneous effects on different types of drugs. Conclusions: This study provides new evidence suggesting that announced performance auditing of primary care providers could directly affect physician behavior even when it is not combined with pay-for-performance, or measures such as reminders, feedback or educational interventions. Keywords: Field experiment, Primary care, Prescription, Information and product quality, Social responsibility JEL-Classification: C93; I11; I18; L15; M14
Background As noted by Arrow [1], asymmetric information about product quality is a fundamental characteristic of the medical care market. The providers of health services are experts who typically hold information that is superior to that of the patients and the payers of the services. When the presence of asymmetric information limits provider quality assurance, it affects the providers’ incentive for quality delivery. Recent health reforms in many countries are designed to encourage quality improvements by linking financial incentives to observable indicators of *Correspondence: [email protected] Department of Health Management and Health Economics, University of Oslo, P.O. Box 1089 Blindern, 0317 Oslo Norway Full list of author information is available at the end of the article 2
quality. When feasible, policymakers often take advantage of advances in information and communication technology in developing of policy measures, such as by designing mechanisms for provider payment based on routinely collected data on provider activity and performance. The Quality and Outcomes Framework (QOF) in the United Kingdom is an example of an extensive pay-forperformance program that relies on advanced infrastructure in the form of health registers and patient lists when measuring provider performance. Many health care systems are still characterized by limited availability of provider performance data and patie
Data Loading...
