Last Updated: 22/04/2020
Incentives for Accurate Diagnosis: Improving Health Care Quality in Mali
Objectives
The main aim of this project is to conduct a follow-on project to identify the leading causes behind over-treatment and test whether alternative incentive regimes can improve care outcomes without producing unnecessary costs. Our analytical framework is motivated by economic models of an “informed expert” selling “a credence good”: the doctor has knowledge about the patient’s illness and needs for treatment that is not verifiable, and the patient must buy the treatment without knowing if it is truly what he or she needs. The model clarifies how doctor incentives, patient incentives, observability of diagnostic test results, and beliefs about test accuracy interact to produce care outcomes in this context.
Finding ways to deliver high-quality health care to low-income populations in developing countries is a critical policy challenge. Our initial ESRC-funded project found that reducing user fees (by providing primary health care for free) does substantially increase Malian households’ use of this care. However, we also find evidence that much of this care may be unnecessary or mistargeted: our data suggest that children seeking care in government-run community clinics (CSCOMs) are frequently prescribed antimalarials and antibiotics when they do not need the treatment. This is particularly striking for malaria, since the Malian government has mandated that malaria diagnoses be confirmed by diagnostic testing.
Aug 2015 — Jul 2017
$313,819
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