{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:07:25Z","timestamp":1747148845611,"version":"3.40.5"},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T00:00:00Z","timestamp":1564617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Economics"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In 2008, the Rural Health Project (Health XI) was initiated in 40 Chinese counties to pilot interventions aimed at improving local health systems. Performance targets were pre\u2010specified (results\u2010based), and project counties were allowed to tailor their interventions (bottom\u2010up) in recognition of the substantial regional variations. Using household data from the China National Health Services Survey in a difference\u2010in\u2010differences strategy combined with matching, we find that project counties have improved outcomes (both incentivized and not\u2010directly\u2010incentivized) in all three domains examined\u2014medical care, public health services, and self\u2010rated health\u2014by 2013. In particular, the decrease in outpatient intravenous drip use and financial strain and the increase in all four components of public health services provision are robust to a variety of tests and alternative matching strategies. Results for not\u2010directly\u2010incentivized indicators suggest that results\u2010based payment did not lead to multitasking problems but rather to positive spillovers. On the other hand, little improvement in inpatient\u2010related indicators suggests that the Health XI interventions did not successfully redress the perverse incentives driving the bulk of providers' income. In general, however, our results indicate that interventions adopted in the results\u2010based bottom\u2010up approach generated substantial benefits given the investment.<\/jats:p>","DOI":"10.1002\/hec.3935","type":"journal-article","created":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T08:04:28Z","timestamp":1564646668000},"page":"1204-1219","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Can a results\u2010based bottom\u2010up reform improve health system performance? Evidence from the rural health project in China"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5083-2214","authenticated-orcid":false,"given":"Hao","family":"Zhang","sequence":"first","affiliation":[{"name":"Erasmus School of Economics Erasmus University Rotterdam  Rotterdam The Netherlands"},{"name":"Tinbergen Institute  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eddy","family":"van Doorslaer","sequence":"additional","affiliation":[{"name":"Erasmus School of Economics Erasmus University Rotterdam  Rotterdam The Netherlands"},{"name":"Tinbergen Institute  Amsterdam The Netherlands"},{"name":"Erasmus School of Health Policy and Management Erasmus University Rotterdam  Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Xu","sequence":"additional","affiliation":[{"name":"Health Human Resources Development Center National Health Commission  Beijing 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