Doctoral Dissertation Research in Economics: Improved Public Primary Healthcare and Informal Provider Responses

了解那些不直接受政策变化影响的人的反应是经济科学的核心部分。 该奖项资助了一项关于非正式提供者如何应对重大公共医疗改革的研究。该研究采用现代研究方法，研究其他供应商如何应对公共卫生政策的变化，特别关注初级卫生保健。 特别是，研究的重点是政策变化如何影响非正规医疗服务提供者提供的服务的质量和数量。 这使研究人员能够衡量政策变化对医疗保健供应商和消费者的直接和间接影响，特别是那些更有可能使用非正规医疗保健服务的低收入人群。该研究将使用调查来收集有关患者，提供者和家庭的丰富数据进行分析。 研究的重点将是政策变化影响不直接受政策变化影响的供应商的机制。 该研究项目的结果可以为改善低收入人群获得更好医疗保健的政策提供重要投入，从而改善他们的健康状况。 本研究计划将利用调查数据，估计需求和非正式提供者行为的结构模型，以评估改善公共医疗服务提供的直接和间接福利效果。 该项目对文献有三个贡献。首先，它利用机会收集了大量的调查数据之前和之后的一个大的公共卫生改革，以分析在低收入环境中改善公共医疗对病人的结果的影响。其次，该项目构建了一个非正式供应商行为的结构模型，解释了价格和质量决策。第三，它使用一种新的标准化患者和提供者和家庭数据的组合来确定模型的关键参数。总的来说，这个框架使研究人员能够研究改善公共初级卫生保健的一般均衡效应，并为未来公共卫生改革的设计和评估提供信息。 该研究成果适用于世界其他地区，因此确立了美国作为全球医疗改革的领导者。该奖项反映了NSF的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

Understanding the response of those not directly affected by policy changes is a central part of economic science. This award funds a research on how informal providers respond to major public health care reforms. The research uses modern research methods to study how other suppliers respond to changes in public health policies with particular focus on primary health care. Particularly, the research focuses on how the policy change affects the quality and quantity of services provided by informal healthcare providers. This allows researchers to measure the total direct and indirect effects of the policy changes on both suppliers and consumers of health care, especially those with low incomes who are more likely to use informal health care services. The research will use surveys to collect rich data on patient, provider, and households for the analyses. The focus of the research will be on the mechanisms through which the policy changes affect providers that are not directly affected by the policy change. The results of this research project can provide important inputs into policies that improve access to better healthcare for low income people, hence improve their health. The research results are applicable to other parts of the world, hence establish the US as the global leader in health care reform.This research project will use survey data to estimate a structural model of demand and informal provider behavior to assess the direct and indirect welfare effects of improved public healthcare provision. The project makes three contributions to the literature. First, it exploits the opportunity to collect an extensive set of survey data before and after a large public health reform to analyze the effects of improved public healthcare on patient outcomes in a low income environment. Second, the project constructs a structural model of informal provider behavior that accounts for price and quality decisions. Third, it uses a novel combination of standardized patients and provider and household data to identify the key parameters of the model. Taken together, this framework allows the researchers to examine the general equilibrium effects of improved public primary healthcare and inform the design and evaluation of future public health reforms. The research results are applicable to other parts of the world, hence establish the US as the global leader in health care reform.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.