Fitzpatrick Anne
University of Massachusetts Boston, Department of Economics, Boston, MA, United States.
J Health Econ. 2022 Jan;81:102544. doi: 10.1016/j.jhealeco.2021.102544. Epub 2021 Nov 17.
In developing countries, public sector health facilities frequently run out of essential medicines ("stockouts"). I test whether anti-malarial drug stockouts affect prices, quality, and overall access to anti-malarial drugs in private sector outlets in Uganda. I combine data from four sources: 1) standardized patient drug purchases; 2) vendor surveys; 3) real customer surveys; 4) public sector supply delivery dates. Using a difference-in-differences approach, I find that stockouts increase private-sector antimalarial drug prices by $0.68, or 35 percent. I find few changes in quality. Real customer characteristics change, suggesting that stockouts lead less educated and poorer customers to drop out of the market. Analysis using the 2016 Demographic and Health Survey additionally shows stockouts reduce treatment at public sector facilities and reduce the likelihood that children receive medicine. My results suggest that stockouts increase prices in the private sector and lead to less equitable health outcomes.
在发展中国家，公共部门的医疗机构经常出现基本药物短缺（“缺货”）的情况。我研究了抗疟药物缺货是否会影响乌干达私营部门药店中抗疟药物的价格、质量以及总体可及性。我整合了来自四个来源的数据：1）标准化患者购药情况；2）供应商调查；3）实际顾客调查；4）公共部门药品供应交付日期。使用双重差分法，我发现缺货使私营部门抗疟药物价格上涨0.68美元，涨幅达35%。我发现质量方面变化不大。实际顾客特征发生了改变，这表明缺货导致受教育程度较低和较贫困的顾客退出市场。利用2016年人口与健康调查进行的分析还显示，缺货减少了公共部门医疗机构的治疗量，并降低了儿童获得药物治疗的可能性。我的研究结果表明，缺货会导致私营部门价格上涨，并导致健康结果的公平性降低。
