Trade-offs between access and quality in healthcare: Evidence from retail clinics in Mexico

Adrian Rubli

Journal of Public Economics, 2023, vol. 224, issue C

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.

Keywords: Primary care; Retail clinics; Provider choice; Quality of care; Prescribing behavior (search for similar items in EconPapers)
JEL-codes: I11 I15 I18 (search for similar items in EconPapers)
Date: 2023
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Persistent link: https://EconPapers.repec.org/RePEc:eee:pubeco:v:224:y:2023:i:c:s0047272723001202

DOI: 10.1016/j.jpubeco.2023.104938

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