[go: up one dir, main page]
IDEAS home Printed from https://ideas.repec.org/p/wbk/wbrwps/9486.html
   My bibliography  Save this paper

Subsidies, Information, and the Timing of Children’s Health Care in Mali

Author

Listed:
  • Sautmann,Anja
  • Brown,Samuel
  • Kline,Dean Mark
Abstract
Sustained progress in reducing child mortality requires better care for children who are acutely ill. This paper studies how health care subsidies and health workers providing information on symptoms affect the overuse and underuse of primary care, which depend not just on absolute levels of demand, but also on whether care is received when the child is actually sick. In a randomized controlled trial of 1,768 children in Mali, the study collected a unique panel of nine weeks of daily symptom and health care use data to study the impact of each policy on demand conditional on need for care, as defined by World Health Organization standards. Subsidies substantially increase care when it is medically indicated, while overuse remains rare. Health worker visits have no aggregate effect on demand, but they may help the youngest children take advantage of the subsidy.

Suggested Citation

  • Sautmann,Anja & Brown,Samuel & Kline,Dean Mark, 2020. "Subsidies, Information, and the Timing of Children’s Health Care in Mali," Policy Research Working Paper Series 9486, The World Bank.
    • Handle: RePEc:wbk:wbrwps:9486
    as

    Download full text from publisher

    File URL: http://documents.worldbank.org/curated/en/880531606763203323/pdf/Subsidies-Information-and-the-Timing-of-Children-s-Health-Care-in-Mali.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    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. Powell-Jackson, Timothy & Hanson, Kara & Whitty, Christopher J.M. & Ansah, Evelyn K., 2014. "Who benefits from free healthcare? Evidence from a randomized experiment in Ghana," Journal of Development Economics, Elsevier, vol. 107(C), pages 305-319.
    3. Das, Jishnu & Hammer, Jeffrey & Sánchez-Paramo, Carolina, 2012. "The impact of recall periods on reported morbidity and health seeking behavior," Journal of Development Economics, Elsevier, vol. 98(1), pages 76-88.
    4. Carolina Lopez & Anja Sautmann & Simone Schaner, 2022. "Does Patient Demand Contribute to the Overuse of Prescription Drugs?," American Economic Journal: Applied Economics, American Economic Association, vol. 14(1), pages 225-260, January.
    5. Donna B. Gilleskie, 1998. "A Dynamic Stochastic Model of Medical Care Use and Work Absence," Econometrica, Econometric Society, vol. 66(1), pages 1-46, January.
    6. 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.
    7. Litvack, Jennie I. & Bodart, Claude, 1993. "User fees plus quality equals improved access to health care: Results of a field experiment in Cameroon," Social Science & Medicine, Elsevier, vol. 37(3), pages 369-383, August.
    8. Edward Miguel & Michael Kremer, 2004. "Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities," Econometrica, Econometric Society, vol. 72(1), pages 159-217, January.
    9. Bryce, J. & Victora, C.G. & Habicht, J.-P. & Vaughan, J.P. & Black, R.E., 2004. "The Multi-Country Evaluation of the Integrated Management of Childhood Illness Strategy: Lessons for the Evaluation of Public Health Interventions," American Journal of Public Health, American Public Health Association, vol. 94(3), pages 406-415.
    10. 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.
    11. Das, Jishnu & Sohnesen, Thomas Pave, 2006. "Patient satisfaction, doctor effort, and interview location : evidence from Paraguay," Policy Research Working Paper Series 4086, The World Bank.
    12. Ari D Johnson & Dana R Thomson & Sidney Atwood & Ian Alley & Jessica L Beckerman & Ichiaka Koné & Djoumé Diakité & Hamed Diallo & Boubacar Traoré & Klenon Traoré & Paul E Farmer & Megan Murray & Joia , 2013. "Assessing Early Access to Care and Child Survival during a Health System Strengthening Intervention in Mali: A Repeated Cross Sectional Survey," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-9, December.
    13. Pascaline Dupas, 2014. "Short‐Run Subsidies and Long‐Run Adoption of New Health Products: Evidence From a Field Experiment," Econometrica, Econometric Society, vol. 82(1), pages 197-228, January.
    14. Amy Finkelstein & Sarah Taubman & Bill Wright & Mira Bernstein & Jonathan Gruber & Joseph P. Newhouse & Heidi Allen & Katherine Baicker, 2012. "The Oregon Health Insurance Experiment: Evidence from the First Year," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(3), pages 1057-1106.
    15. Das, Jishnu & Hammer, Jeffrey, 2005. "Which doctor? Combining vignettes and item response to measure clinical competence," Journal of Development Economics, Elsevier, vol. 78(2), pages 348-383, December.
    16. 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.
    17. Santos Silva, Joao M. C. & Windmeijer, Frank, 2001. "Two-part multiple spell models for health care demand," Journal of Econometrics, Elsevier, vol. 104(1), pages 67-89, August.
    18. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-277, June.
    19. Jishnu Das, 2011. "The Quality of Medical Care in Low-Income Countries: From Providers to Markets," PLOS Medicine, Public Library of Science, vol. 8(4), pages 1-2, April.
    20. Kenneth L. Leonard & Gilbert R. Mliga & Damen Haile Mariam, 2002. "Bypassing Health Centres in Tanzania: Revealed Preferences for Quality," Journal of African Economies, Centre for the Study of African Economies, vol. 11(4), pages 441-471, December.
    21. Jimenez, Emmanuel, 1995. "Human and physical infrastructure: Public investment and pricing policies in developing countries," Handbook of Development Economics, in: Hollis Chenery & T.N. Srinivasan (ed.), Handbook of Development Economics, edition 1, volume 3, chapter 43, pages 2773-2843, Elsevier.
    22. Ashraf, Nava & Jack, B. Kelsey & Kamenica, Emir, 2013. "Information and subsidies: Complements or substitutes?," Journal of Economic Behavior & Organization, Elsevier, vol. 88(C), pages 133-139.
    23. Vaughan, R., 2004. "Evaluation and Public Health," American Journal of Public Health, American Public Health Association, vol. 94(3), pages 360-360.
    24. 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.
    25. 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.
    26. Keeler, Emmett B. & Rolph, John E., 1988. "The demand for episodes of treatment in the health insurance experiment," Journal of Health Economics, Elsevier, vol. 7(4), pages 337-367, December.
    27. Das, Jishnu & Sanchez-Paramo, Carolina, 2003. "Short but not sweet - new evidence on short duration morbidities from India," Policy Research Working Paper Series 2971, The World Bank.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Kline,Dean Mark & Sautmann,Anja, 2022. "The Effects of Community Health Worker Visits and Primary Care Subsidies on Health Behaviorand Health Outcomes for Children in Urban Mali," Policy Research Working Paper Series 9986, The World Bank.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Anja Sautmann & Samuel Brown & Mark Dean, 2016. "Subsidies, Information, and the Timing of Childrenís Health Care in Mali," Working Papers 2016-2, Brown University, Department of Economics.
    2. Pascaline Dupas & Edward Miguel, 2016. "Impacts and Determinants of Health Levels in Low-Income Countries," NBER Working Papers 22235, National Bureau of Economic Research, Inc.
    3. Vinish Shrestha & Rashesh Shrestha, 2023. "The Combined Role of Subsidy and Discussion Intervention in the Demand for a Stigmatized Product," The World Bank Economic Review, World Bank, vol. 37(4), pages 675-705.
    4. Carolina Lopez & Anja Sautmann & Simone Schaner, 2018. "The Contribution of Patients and Providers to the Overuse of Prescription Drugs," NBER Working Papers 25284, National Bureau of Economic Research, Inc.
    5. Paulina Oliva & B. Kelsey Jack & Samuel Bell & Elizabeth Mettetal & Christopher Severen, 2020. "Technology Adoption under Uncertainty: Take-Up and Subsequent Investment in Zambia," The Review of Economics and Statistics, MIT Press, vol. 102(3), pages 617-632, July.
    6. Meredith, Jennifer & Robinson, Jonathan & Walker, Sarah & Wydick, Bruce, 2013. "Keeping the doctor away: Experimental evidence on investment in preventative health products," Journal of Development Economics, Elsevier, vol. 105(C), pages 196-210.
    7. Rebecca Dizon-Ross & Pascaline Dupas & Jonathan Robinson, 2015. "Governance and the Effectiveness of Public Health Subsidies," NBER Working Papers 21324, National Bureau of Economic Research, Inc.
    8. Anup Malani & Cynthia Kinnan & Gabriella Conti & Kosuke Imai & Morgen Miller & Shailender Swaminathan & Alessandra Voena & Bartosz Woda, 2024. "Evaluating pricing health insurance in lower-income countries: A field experiment in India," IFS Working Papers W24/33, Institute for Fiscal Studies.
    9. B Kelsey Jack, "undated". "Market Inefficiencies and the Adoption of Agricultural Technologies in Developing Countries," CID Working Papers 50, Center for International Development at Harvard University.
    10. Hoffmann, Bridget, 2018. "Do non-monetary prices target the poor? Evidence from a field experiment in India," Journal of Development Economics, Elsevier, vol. 133(C), pages 15-32.
    11. Okeke, Edward N. & Adepiti, Clement A. & Ajenifuja, Kayode O., 2013. "What is the price of prevention? New evidence from a field experiment," Journal of Health Economics, Elsevier, vol. 32(1), pages 207-218.
    12. 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.
    13. Malani, Anup & Kinnan, Cynthia & Conti, Gabriella & Imai, Kosuke & Miller, Morgen & Swaminathan, Shailender & Voena, Alessandra & Woda, Bartek, 2024. "Evaluating and pricing health insurance in lower-income countries: A field experiment in India," CEPR Discussion Papers 19326, C.E.P.R. Discussion Papers.
    14. 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.
    15. Larrú, José María, 2012. "Evaluar para aprender. Eficiencia en salud y desarrollo [Evaluating for learning. Efficiency in health and development]," MPRA Paper 38788, University Library of Munich, Germany.
    16. Toshiaki Iizuka & Hitoshi Shigeoka, 2018. "Free for Children? Patient Cost-sharing and Healthcare Utilization," NBER Working Papers 25306, National Bureau of Economic Research, Inc.
    17. Cariappa, A.G. Adeeth & Chandel, B.S. & Sendhil, R. & Dixit, Anil Kumar & Sankhala, Gopal & Mani, Veena & Meena, B.S., 2022. "Do the prices of a preventive animal health product affect dairy farmers’ willingness to pay and product use? Evidence from an experimental study," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 100(C).
    18. Molina Millán, Teresa & Macours, Karen, 2017. "Attrition in Randomized Control Trials: Using Tracking Information to Correct Bias," IZA Discussion Papers 10711, Institute of Labor Economics (IZA).
    19. Levine, David & Polimeni, Rachel & Ramage, Ian, 2016. "Insuring health or insuring wealth? An experimental evaluation of health insurance in rural Cambodia," Journal of Development Economics, Elsevier, vol. 119(C), pages 1-15.
    20. Gunther Bensch & Jörg Peters, 2020. "One‐Off Subsidies and Long‐Run Adoption—Experimental Evidence on Improved Cooking Stoves in Senegal," American Journal of Agricultural Economics, John Wiley & Sons, vol. 102(1), pages 72-90, January.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wbk:wbrwps:9486. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Roula I. Yazigi (email available below). General contact details of provider: https://edirc.repec.org/data/dvewbus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.