Banerjee Abhijit V, Glennerster Rachel, Duflo Esther
MIT and Abdul Latif Jameel Poverty Action Lab.
J Eur Econ Assoc. 2008;6(2-3):487-500. doi: 10.1162/JEEA.2008.6.2-3.487.
The public Indian health care system is plagued by high staff absence, low effort by providers, and limited use by potential beneficiaries who prefer private alternatives. This artice reports the results of an experiment carried out with a district administration and a nongovernmental organization (NGO). The presence of government nurses in government public health facilities (subcenters and aid-posts) was recorded by the NGO, and the government took steps to punish the worst delinquents. Initially, the monitoring system was extremely effective. This shows that nurses are responsive to financial incentives. But after a few months, the local health administration appears to have undermined the scheme from the inside by letting the nurses claim an increasing number of "exempt days." Eighteen months after its inception, the program had become completely ineffective.
印度公共医疗体系饱受员工缺勤率高、医疗服务提供者工作积极性低以及潜在受益者因更青睐私立医疗服务而利用率有限等问题的困扰。本文报道了一项与地区行政部门和一个非政府组织（NGO）合作开展的实验结果。该NGO记录了政府护士在政府公共卫生机构（基层医疗中心和卫生站）的出勤情况，政府采取措施惩处表现最差的违规者。起初，监测系统极为有效。这表明护士对经济激励措施有反应。但几个月后，当地卫生行政部门似乎从内部破坏了该计划，允许护士申报越来越多的“豁免日”。该计划启动18个月后，已变得完全无效。
