The Effects of Primary Care Chronic-Disease Management in Rural China

Yiwei Chen, Hui Ding, Min Yu, Jieming Zhong, Ruying Hu, Xiangyu Chen, Chunmei Wang, Kaixu Xie and Karen Eggleston

No 26100, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: Health systems globally face increasing morbidity and mortality from chronic diseases, yet many - especially in low- and middle-income countries - lack strong chronic disease management in primary health care (PHC). We provide evidence on China’s efforts to promote PHC management using unique five-year panel data in a rural county, including health care utilization from medical claims and health outcomes from biomarkers. Utilizing plausibly exogenous variation in management intensity generated by administrative and geographic boundaries, we compare hypertension/diabetes patients in villages within two kilometers distance but managed by different townships. Results show that, compared to patients in townships with median management intensity, patients in high-intensity townships have 4.8% more PHC visits, 5.2% fewer specialist visits, 11.7% fewer inpatient admissions, and 3.6% lower medical spending. They also tend to have better medication adherence and better control of blood pressure. The resource savings from avoided inpatient admissions substantially outweigh the costs of the program.

JEL-codes: I11 I18 (search for similar items in EconPapers)
Date: 2019-07
New Economics Papers: this item is included in nep-cna, nep-hea and nep-tra
Note: EH
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