Health facility quality peer effects: Are financial incentives necessary?

IF 3.5 2区 经济学 Q1 ECONOMICS Regional Science and Urban Economics Pub Date : 2025-02-21 DOI:10.1016/j.regsciurbeco.2025.104091
Finn McGuire , Rita Santos , Peter C. Smith , Nicholas Stacey , Ijeoma Edoka , Noemi Kreif
{"title":"Health facility quality peer effects: Are financial incentives necessary?","authors":"Finn McGuire ,&nbsp;Rita Santos ,&nbsp;Peter C. Smith ,&nbsp;Nicholas Stacey ,&nbsp;Ijeoma Edoka ,&nbsp;Noemi Kreif","doi":"10.1016/j.regsciurbeco.2025.104091","DOIUrl":null,"url":null,"abstract":"<div><div>This paper examines peer effects in health facility quality in South Africa. Specifically, we investigate whether health facilities adapt their quality in response to changes in the quality of peer facilities, even in the absence of material incentives for doing so. Using a national census of public primary health facilities, we exploit data on structural and process components of quality, examining how these measures change from 2015 to 2017. We examine facilities strategic interactions using both a spatial econometrics approach and a more traditional quasi-experimental approach exploiting a quality improvement program as a source of exogeneous variation to estimate the response of facilities to changes in the quality of their peers. We find evidence of quality peer effects between primary health care facilities, with a 10-unit increase in average District facility quality causing facilities to increase their quality by 3.6 units. Given the lack of financial incentives, we propose prosocial motivation and reputational concerns as the mechanism inducing facilities to respond to changes in peer quality. This finding is consistent with recent literature which has stressed the role measurement and public reporting can play in improving public service, and particularly health care, provision. Importantly, our findings have significant policy implications suggesting the provision of relative performance information, allowing for peer comparisons, can induce a form of quality yardstick competition and be a credible quality improvement policy which may be considered alongside health financing reforms.</div></div>","PeriodicalId":48196,"journal":{"name":"Regional Science and Urban Economics","volume":"112 ","pages":"Article 104091"},"PeriodicalIF":3.5000,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Regional Science and Urban Economics","FirstCategoryId":"96","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0166046225000080","RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ECONOMICS","Score":null,"Total":0}
引用次数: 0

Abstract

This paper examines peer effects in health facility quality in South Africa. Specifically, we investigate whether health facilities adapt their quality in response to changes in the quality of peer facilities, even in the absence of material incentives for doing so. Using a national census of public primary health facilities, we exploit data on structural and process components of quality, examining how these measures change from 2015 to 2017. We examine facilities strategic interactions using both a spatial econometrics approach and a more traditional quasi-experimental approach exploiting a quality improvement program as a source of exogeneous variation to estimate the response of facilities to changes in the quality of their peers. We find evidence of quality peer effects between primary health care facilities, with a 10-unit increase in average District facility quality causing facilities to increase their quality by 3.6 units. Given the lack of financial incentives, we propose prosocial motivation and reputational concerns as the mechanism inducing facilities to respond to changes in peer quality. This finding is consistent with recent literature which has stressed the role measurement and public reporting can play in improving public service, and particularly health care, provision. Importantly, our findings have significant policy implications suggesting the provision of relative performance information, allowing for peer comparisons, can induce a form of quality yardstick competition and be a credible quality improvement policy which may be considered alongside health financing reforms.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
5.30
自引率
9.70%
发文量
63
期刊介绍: Regional Science and Urban Economics facilitates and encourages high-quality scholarship on important issues in regional and urban economics. It publishes significant contributions that are theoretical or empirical, positive or normative. It solicits original papers with a spatial dimension that can be of interest to economists. Empirical papers studying causal mechanisms are expected to propose a convincing identification strategy.
期刊最新文献
Editorial Board Does it take extra skills to work in a large city? Health facility quality peer effects: Are financial incentives necessary? Equal price for equal place? Demand-driven racial discrimination in the housing market Voluntary retirement savings in China: A spatial ordered probit approach
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1