当医生从天而降：缓解医生供给约束对死亡率的影响

中文摘要

本文介绍了一项与尼日利亚政府协调开展的政策实验的结果。在该实验中，一些社区被随机选中，获得一名新医生。这些医生被派往服务相应社区的公共卫生中心工作一年。在他们到来之前，医疗服务由中级医疗服务提供者（MLP）提供。为了将（据称更高的）质量所产生的影响与数量所产生的影响区分开来，另一组社区获得了一名额外的中级医疗服务提供者。第三组社区则没有获得任何额外工作人员。除此之外，实验未提供其他投入。我发现，被分配医生的社区死亡率出现了可测量的下降，而被分配额外一名MLP的社区并未出现这种下降。这表明，医疗卫生部门的服务质量是一个重要制约因素。

Abstract

This paper describes the results of a policy experiment conducted in coordination with the Nigerian government. In this experiment, some communities were randomly selected to receive a new doctor. These doctors were posted to the public health center serving the community to work for a year. Prior to their arrival, health care was provided by mid-level health care providers (MLP). To separate the effect of (ostensibly higher) quality from that of quantity, another group of communities was provided with an additional mid-level health care worker. A third group of communities received no additional workers. No other inputs were provided. I find a measurable decrease in mortality in communities assigned a doctor but not in communities assigned an additional MLP, suggesting that quality in the health care sector is a significant constraint.