Analysis of hospital technical efficiency in China: Effect of health insurance reform

Hu, Hsin Hui; Qi, Qing-Hui; Yang, Chih Hai

doi:10.1016/j.chieco.2012.04.008

Cited by 86 publications

(102 citation statements)

References 39 publications

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“…Our analysis includes the province-level data of Chinese hospitals available over the period 2002 to 2013 (372 observations) due to the hospital-level data being rarely disclosed, which cover much longer period than previous research on China, like Ng [13] and Hu et al [14]. This province-level data was obtained from China's Health Statistical Yearbook that published by MOH of China during 2003-2014.…”

Section: Background Literature and Descriptive Datamentioning

confidence: 99%

“…According to the data of China's Health Statistical Yearbook, the proportion of total assets of private hospitals just account for 4.07% at end of 2013 in China. The criteria used for adopting the inputs and the outputs variables are the practices according to the previous research on hospital efficiency, which include Jacobs [6], Hu et al [14], Barros et al [15,16], Koop et al [41], Rosko and Mutter [42], Varabyova and Schreyögg [43], Li et al [10], and the accessibility of the data of Chinese hospitals, so that to rigorously estimate the technical efficiency [10]. For the inputs, we choose the total staff, the total assets and the number of beds, which stands for the labor, the capital and the capacity, respectively.…”

Section: Background Literature and Descriptive Datamentioning

confidence: 99%

“…Alternatively, a reduction in any input must require an increase in at least one other input or a decrease in at least one output [9,10]. In the literature, there are two main approaches are employed to evaluate the technical efficiency of hospitals, including the DEA (Data Envelop Analysis) and SFA (Stochastic Frontier Analysis) [6,[11][12][13][14][15][16][17]. As mentioned above and the contextual setting that will be introduced later, the medical sector of China is still in transition and facing great challenges.…”

Section: Introductionmentioning

confidence: 99%

“…Hu et al [14] use the Tobit model to analyze the effects of some factors on the technical efficiency of Chinese hospitals, including the coastal location, public subsidies, the social medical insurance reform, the ratio of third-class hospitals to total hospitals and population characteristics. In addition, they conclude that the former two have insignificant effect on improving the technical efficiency, while the latter two significantly promote the technical efficiency.…”

Section: Introductionmentioning

confidence: 99%

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The Efficiency and Its Determinants for China’s Medical Care System: Some Policy Implications for Northeast Asia

2015

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Abstract:The medical care system in China has experienced significant changes during three decades of reform, and thus result in a need to investigate the effects of medical reform. This paper investigates the technical efficiency of Chinese hospitals in 31 provinces during the period from 2002 to 2013 by proposing a new global generalized directional distance function (GGDDF) approach taking account of undesirable output, i.e., mortality. Results show that despite the technical efficiency had being improved with time trend, most Chinese provinces are not performing well on hospitals' technical efficiency and leave a large potential to improve. Some provinces display better performance compared to other provinces of China. We further investigate the factors that affect the technical efficiency of Chinese hospitals with Tobit models. It concludes that the medical insurance reforms have improved the performance of Chinese hospitals, while public subsidies have decreased it. The provinces with higher GDP per capital and population density, the performance of their hospitals is better. The related policy implications for Northeast Asia are derived, including encouraging the development of private hospitals, enlarging the coverage of medical services, and pursuing different policies for the provinces with higher GDP per capital and population density. OPEN ACCESSSustainability 2015, 7 14093

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Section: Background Literature and Descriptive Datamentioning

confidence: 99%

Section: Background Literature and Descriptive Datamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Efficiency and Its Determinants for China’s Medical Care System: Some Policy Implications for Northeast Asia

2015

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“…Tal característica diferencia a DEA de outras técnicas analíticas com uma única dimensão, como, por exemplo, a análise de regressão e correlação (Hu, Qi, & Yang, 2012). Uma das principais funcionalidades do modelo é que ele converte várias saídas e entradas em uma escala de medida de eficiência e constrói uma fronteira, não paramétrica, das DMUs que são utilizadas como parâmetro de eficiência, permitindo assim uma ação comparativa (Hu, Qi, & Yang, 2012).…”

Section: Revista De Gestão Em Sistemas De Saúde -Rgssunclassified

Avaliação da Eficiência Hospitalar por Meio da Análise Envoltória de Dados

Silva¹,

Moretti²,

Schuster³

2016

RGSS

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RESUMOÉ constante o interesse em se analisar a eficiência dos hospitais e também dos serviços prestados a partir da utilização de recursos públicos, visto a magnitude dos recursos utilizados, que são geralmente escassos, e a complexidade que envolve a prestação de serviço de assistência à saúde. Nesse sentido, o estudo objetivou avaliar, por meio da Análise Envoltória de Dados (DEA), a eficiência produtiva de hospitais credenciados ao Sistema Único de Saúde (SUS) na região sul do Brasil. A partir de uma pesquisa documental, descritiva, retrospectiva e com abordagem quantitativa. Foi analisada uma amostra de 139 hospitais localizados em municípios com mais de 100 mil habitantes dos estados do Paraná, Rio Grande do Sul e Santa Catarina. Com intuito de garantir melhores comparativos dos resultados, aplicou-se a técnica de clusters para agrupar os municípios semelhantes quanto aos seus inputs. Os resultados demonstraram que dentre os hospitais analisados, nos três clusters, o score máximo de eficiência foi atingido por 34% dos hospitais catarinenses, 49% dos hospitais paranaenses e 35% dos hospitais riograndenses. Também se pode inferir que 41% dos hospitais analisados são eficientes e utilizaram de forma eficiente os recursos físicos e pessoais disponíveis ao atendimento da população através do SUS. Por não se identificar discrepância significativa, quanto aos scores de eficiência nos hospitais ineficientes, constatou-se que estes estão, na sua maioria, próximos da fronteira de eficiência.Palavras-chave: Administração Hospitalar; Análise Envoltória de Dados; Eficiência; Sistema Único de Saúde; Saúde Pública. HOSPITAL EFFICIENCY ASSESSMENT THROUGH DATA ENVELOPMENT ANALYSIS ABSTRACTInterest in analyzing the efficiency of hospitals and also the services provided from the use of public resources is nonstop, given the magnitude of the resources used, which are generally scarce, and the complexity involved in the provision of health care service. In this sense, the study aimed to evaluate, using data envelopment analysis (DEA), the productive efficiency of hospitals affiliated to the Unified Health System (SUS) in Southern Brazil, by way of a documentary, descriptive, retrospective and quantitative approach research. A sample of 139 hospitals located in cities with more than 100 thousand inhabitants in the states of Paraná, Rio Grande do Sul and Santa Catarina was analysed. In order to ensure better comparative results, the Clusters technique was applied to groups with similar municipalities as their inputs. The results show that among the hospitals analyzed in three groups, the maximum efficiency scores achieved were 34% of Santa Catarina hospitals, 49% of Paraná hospitals and 35% of Rio Grande hospitals. It can also be inferred that 41% of the hospitals surveyed are efficient and use efficiently the physical and personal resources available to the population's care through the SUS. Because no significant discrepancies were identified as to the scores efficiency in inefficient hospitals, it was found that most of them a...

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Limited knowledge and distrust are important social factors of out‐patient’ s ‘inappropriate diagnosed seeking behaviour’: a qualitative research in Shanghai

Ruan

Zhuang

Chen

et al. 2021

Health Planning & Management

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Aims: This study is designed to present out-patient's 'inappropriate diagnosed seeking behaviour' in tertiary hospitals and interpret its association with some potential social factors.Methods: A qualitative study based on grounded theory was designed in this paper. The participates were recruited by a two-stage process. The field observation and in-depth interview were adopted for data collection. Multi-round (five rounds) sampling and continuing data analysis were adopted as well.Results: Totally 26 out-patients from three tertiary hospitals in Shanghai were involved. Four focused codes, including 'limited policy-related knowledge', 'limited healthrelated knowledge', 'distrust on related policy' and 'distrust on medical networks', were identified. Then, a theoretical model about the association of out-patient's 'limited knowledge' with 'distrust' and its relationship with 'inappropriate first-diagnosed seeking behaviour' in tertiary hospitals was developed. Conclusion:'Inappropriate first-diagnosed seeking behaviour' of the out-patients in tertiary hospitals is closely associated with their limited knowledge and related distrust. Great effort on improving publics' knowledge and rebuilding a benign trust relationship with out-patients and

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Analysis of hospital technical efficiency in China: Effect of health insurance reform

Cited by 86 publications

References 39 publications

The Efficiency and Its Determinants for China’s Medical Care System: Some Policy Implications for Northeast Asia

The Efficiency and Its Determinants for China’s Medical Care System: Some Policy Implications for Northeast Asia

Avaliação da Eficiência Hospitalar por Meio da Análise Envoltória de Dados

Limited knowledge and distrust are important social factors of out‐patient’ s ‘inappropriate diagnosed seeking behaviour’: a qualitative research in Shanghai

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