The Effects of Primary Care Chronic-Disease Management in Rural China

58 Pages Posted: 2 Aug 2019 Last revised: 26 Apr 2023

See all articles by Yiwei Chen

Yiwei Chen

Stanford University - Department of Economics

Hui Ding

Stanford University

Min Yu

Zhejiang Provincial Center for Disease Control and Prevention - Department of Non-Communicable Disease Control and Prevention

Jieming Zhong

Zhejiang Provincial Center for Disease Control and Prevention

Ruying Hu

Zhejiang Provincial Center for Disease Control and Prevention - Department of Non-Communicable Disease Control and Prevention

Xiangyu Chen

Zhejiang Provincial Center for Disease Control and Prevention

Chunmei Wang

Southern Medical University

Kaixu Xie

Tongxiang Center for Disease Control and Prevention

Karen Eggleston

Stanford University - Walter H. Shorenstein Asia-Pacific Research Center (APARC)

Date Written: July 2019

Abstract

Health systems globally face increasing morbidity and mortality from chronic diseases, yet many - especially in low- and middle-income countries - lack strong chronic disease management in primary health care (PHC). We provide evidence on China’s efforts to promote PHC management using unique five-year panel data in a rural county, including health care utilization from medical claims and health outcomes from biomarkers. Utilizing plausibly exogenous variation in management intensity generated by administrative and geographic boundaries, we compare hypertension/diabetes patients in villages within two kilometers distance but managed by different townships. Results show that, compared to patients in townships with median management intensity, patients in high-intensity townships have 4.8% more PHC visits, 5.2% fewer specialist visits, 11.7% fewer inpatient admissions, and 3.6% lower medical spending. They also tend to have better medication adherence and better control of blood pressure. The resource savings from avoided inpatient admissions substantially outweigh the costs of the program.

Suggested Citation

Chen, Yiwei and Ding, Hui and Yu, Min and Zhong, Jieming and Hu, Ruying and Chen, Xiangyu and Wang, Chunmei and Xie, Kaixu and Eggleston, Karen, The Effects of Primary Care Chronic-Disease Management in Rural China (July 2019). NBER Working Paper No. w26100, Available at SSRN: https://ssrn.com/abstract=3430137

Yiwei Chen (Contact Author)

Stanford University - Department of Economics ( email )

Landau Economics Building
579 Serra Mall
STANFORD, CA 94305-6072
United States

Hui Ding

Stanford University ( email )

Stanford, CA 94305
United States

Min Yu

Zhejiang Provincial Center for Disease Control and Prevention - Department of Non-Communicable Disease Control and Prevention ( email )

Hangzhou
China

Jieming Zhong

Zhejiang Provincial Center for Disease Control and Prevention ( email )

Binjiang
Hangzhou, 310051
China

Ruying Hu

Zhejiang Provincial Center for Disease Control and Prevention - Department of Non-Communicable Disease Control and Prevention ( email )

Hangzhou
China

Xiangyu Chen

Zhejiang Provincial Center for Disease Control and Prevention ( email )

Binjiang
Hangzhou, Zhejiang 310051
China

Chunmei Wang

Southern Medical University ( email )

Guangzhou, Guangdong Province
China

Kaixu Xie

Tongxiang Center for Disease Control and Prevention ( email )

China

Karen Eggleston

Stanford University - Walter H. Shorenstein Asia-Pacific Research Center (APARC) ( email )

Stanford, CA 94305
United States

Do you have negative results from your research you’d like to share?

Paper statistics

Downloads
17
Abstract Views
546
PlumX Metrics