Do Health Reforms to Improve Quality Have Long‐Term Effects? Results of a Follow‐Up on a Randomized Policy Experiment in the Philippines
追踪菲律宾一项随机政策实验中参与医生的医疗质量，发现干预措施停止5年后，干预组质量仍显著高于对照组，且质量评分年衰减率低于1%。
We tracked doctors who had previously participated in a randomized policy experiment in the Philippines. The original experiment involved 30 district hospitals divided equally into one control site and two intervention sites that increased insurance payments (full insurance support for children under 5 years old) or made bonus payments to hospital staff. During the 3 years of the intervention, quality-as measured by clinical performance and value vignettes-improved and was sustained in both intervention sites compared with controls. Five years after the interventions were discontinued, we remeasured the quality of care of the doctors. We found that the intervention sites continued to have significantly higher quality compared with the control sites. The previously documented quality improvement in intervention sites appears to be sustained; moreover, it was subject to a very low (less than 1% per year) rate of decay in quality scores.