| Summary/Abstract |
Village health stations (VHSs) are core providers of health services in rural China, responsible for almost a quarter of all consultations and outpatient services nationwide. During the reform period, misfit regulatory institutions have negatively influenced the quality of their services, as they require self-employed doctors mainly funded through out-of-pocket payments to provide unprofitable preventive care, and cheap primary care services. This study explores the effects of health reforms on VHSs over the last two decades, arguing that the institutional ambiguity resulting from these misfit institutions negatively affected the outcomes of core health reforms. This is evident in the stronger performance of VHSs where doctors are salaried employees. Recent pricing reforms may also come to improve the performance of the private sector.
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