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The effect of a mystery shopper scheme on prescribing behavior in primary care: Results from a field experiment

Roland Cheo (), Ge Ge, Geir Godager (), Rugang Liu (), Jian Wang () and Qiqi Wang ()
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Roland Cheo: Center for Economic Research, Shandong University
Ge Ge: Department of Health Management and Health Economics, University of Oslo
Rugang Liu: School of Health Policy & Management, Nanjing Medical University
Jian Wang: Dong Fureng Institute of Economic and Social Development, Wuhan University
Qiqi Wang: School of Economics, Xi’an University of Finance and Economics

Health Economics Review, 2020, vol. 10, issue 1, 1-19

Abstract: 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; C93; I11; I18; L15; M14 (search for similar items in EconPapers)
Date: 2020
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DOI: 10.1186/s13561-020-00290-z

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