Asia Health Policy Program working paper # 62
January 7, 2021
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, villages within two kilometers distance but managed by different townships, we find that villagers with hypertension/diabetes residing in a township with more intensive PHC management had a relative increase in PHC visits during the five-year period, as well as fewer specialist visits, fewer hospital admissions, lower inpatient spending, better medication adherence, and better control of blood pressure. A back-of-the-envelope estimate suggests that the resource savings from avoided inpatient admissions alone substantially outweigh the costs of the program.