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

理解那些没有直接受到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卫生保健改革的研究。本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，尤其侧重于初级卫生保健。特别是，研究侧重于政策变化如何影响非正规保健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提供者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式医疗保健服务的低收入者。该研究将通过调查收集患者、提供者和家庭的丰富数据进行分析。研究的重点将放在政策变化对没有直接受到政策变化影响的提供者产生影响的机制上。这一研究项目的结果可以为改善低收入者获得更好医疗保健的机会的政策提供重要投入，从而改善他们的健康。研究结果适用于世界其他地区，从而确立了美国在医疗改革方面的全球领导者地位。本研究项目将使用调查数据来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保健提供的直接和间接福利效应。该项目对文献有三个贡献。首先，本文利用收集大规模公共卫生改革前后大量调查数据的机会，分析改善公共卫生保健对低收入环境中患者结果的影响。其次，该项目构建了一个非正式供应商行为的结构模型，该模型考虑了价格和质量决策。第三，采用标准化患者、提供者和家庭数据的新颖组合来确定模型的关键参数。综上所述，该框架使研究人员能够检查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。研究结果适用于世界其他地区，从而确立了美国在医疗改革方面的全球领导者地位。该奖项反映了美国国家科学基金会的法定使命，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.