Private or public hospital ownership: Does it really matter?

Bjorvatn, Afsaneh

doi:10.1016/j.socscimed.2017.11.038

Cited by 23 publications

(19 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For instance, these patients account for about 15% of all hospital admissions in Norway. 18 To explore cardiologists' professional judgements about patient eligibility for specialist health care services, we conducted a vignette survey among cardiologists in Denmark and Norway. As part of the survey, the respondents were asked to read two standardized case vignettes in the form of patient referrals and to assess (1) whether the patient described in the referral was eligible for (i.e.…”

Section: Introductionmentioning

confidence: 99%

Law and medical practice: A comparative vignette survey of cardiologists in Norway and Denmark

2020

Self Cite

View full text Add to dashboard Cite

Objective: This article explores the implications of legal regulation for medical discretion and decision-making in Norway and Denmark. Methods: The article is based on a cross-national cross-sectional survey exploring cardiologists’ assessments of patient eligibility for specialist health care. Forty-two cardiologists in Norway and 48 in Denmark were presented with two standardized case vignettes in the form of patient referrals and were asked to assess whether the patient was eligible for treatment by a specialist, and if so, what waiting time would be assigned to the patient. Results: Primarily based on descriptive statistics, our findings indicate interesting similarities and variations. While there was only minor variation across the countries in cardiologists’ professional assessments about a patient with a more severe condition, judgements of eligibility for specialist treatment varied for a patient with a less severe medical condition. Moreover, Danish cardiologists distinguished between the more severe and less severe conditions to a much lesser extent when assessing eligibility for specialist treatment. For waiting times, there was considerable variation at the general level, from 1 week to 6 months. The assigned waiting times were on average double those for Norwegian cardiologists compared with their Danish counterparts. Denmark’s legal standardization of waiting times appears to lead to shorter waiting times than those prescribed by Norway’s legal regulations. Conclusion: For a single clear overall intention with a new policy, simpler legal regulations may be more effective than very detailed and specific requirements. If policymakers’ overall intention is for medical doctors to make complex decisions involving the prioritization of patients, then more individualized regulations seem to be a better tool.

show abstract

Section: Introductionmentioning

confidence: 99%

Law and medical practice: A comparative vignette survey of cardiologists in Norway and Denmark

2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, a series of policies aimed at facilitating private hospitals' expansion has long been controversial as private hospitals tend to provide therapy procedures for particular disease groups with relatively high-profit margins. 43 …”

Section: Discussionmentioning

confidence: 99%

Creating accountable hospital service areas in China: a case analysis of health expenditure in the metropolis of Chengdu

et al. 2022

View full text Add to dashboard Cite

ObjectivesTo delineate hospital service areas (HSAs) using the Dartmouth approach in China and identify the hypothesised demand-side, supply-side and region-specific factors of health expenditure within HSAs.DesignPopulation-based descriptive study.SettingWe selected the metropolis of Chengdu, one of the three most populous cities in China as a case for the analysis, where approximately 16.33 million residents living.ParticipantsIndividual-level in-patient discharge records (n=904 298) during the fourth quarter of 2018 (from 1 September to 31 December) were extracted from Sichuan Health Commission. Cases of non-residents of Chengdu were excluded from the datasets.MethodsWe conducted three sets of analyses: (1) apply Dartmouth approach to delineate HSAs; (2) use Geographic Information System (GIS)-based method to demonstrate health expenditure variations across delineated HSAs and (3) employ a three-level multilevel linear model to examine the association between health expenditure and demand-side, supply-side and region-specific factors.ResultsA total of 113 HSAs with a median population of 60 472 (ranging from 7022 to 827 750) was delineated. Total in-patient expenditure per admission varied more than threefold across HSAs after adjusting for age and gender. Apart from a list of demand-side factors, an increased number of physicians, healthcare facilities at higher levels and for-profit healthcare facilities were significantly associated with increased total in-patient expenditures. At the HSA level, the proportion of private healthcare facilities located in a single HSA was associated with increased total in-patient expenditure generated by that HSA, while the increased number of healthcare facilities in a HSA was negatively associated with the total in-patient expenditures.ConclusionHSAs were delineated to help establish an accountable healthcare delivery system, which serves as local hospital markets to provide in-patient healthcare via connecting demanders with suppliers inside particular HSAs. Policy-makers should adopt HSAs to identify variations of total in-patient expenditures among different areas and the potential associated factors. Findings from the HSA-based analysis could inform the formulation of relevant health policies and the optimisation of healthcare resource allocations.

show abstract

“…Many studies had found that hospital ownership matters for the equity of Medical Outcomes. Some studies had found that private hospitals had better therapeutic outcomes [30][31][32][33], some had found that not-for-profit hospitals had better therapeutic outcomes [34][35][36], while others have found that for-profit hospitals had better the equity of Medical Outcomes [37]. However, some studies had found no difference in therapeutic outcomes by ownership type in America [38][39][40][41].…”

Section: Discussionmentioning

confidence: 99%

The Different Classification of Hospitals Impact on the Equity of Medical Outcomes of Patients in China

Zeng

2021

Preprint

View full text Add to dashboard Cite

Background: In the context of Healthy China Strategy, the traditional idea that large hospitals provide better medical care is still deeply rooted in people's minds. The characteristics of the medical inverted pyramid structure—higher-level medical institutions are overwhelmed, while lower-level medical institutions are deserted—have existed for a long time. Because of the unreasonable allocation of resources, it is difficult to meet the healthcare needs of citizens and to establish a tiered delivery system. The objective of this paper is to study the effect of different classification of hospitals (COH) on the equity of Medical Outcomes of patients.Methods: The data used was from Urban Employee Basic Medical Insurance (UEBMI) enrolment records of Chengdu. We conducted a retrospective study and used Nested Multinomial Logit Model (NMNL) to estimate the effect of COH on the equity of Medical Outcomes.Results: COH had a significant effect on the equity of Medical Outcomes, but the effectiveness and direction of the hospital level on different outcomes were not consistent. The reimbursement rate, medical expenditures, gender, age, disease type and others factors were associated with the effect(p<0.01); length of stay has a limited effect on health outcomes. It was not the case that the longer the hospital stay was, the higher the quality of care would be. When COH was distinguished, there were significant differences in the effect of different levels of hospitals on the equity of Medical Outcomes. Horizontally speaking, hospitals of the same level had different effects on different the equity of Medical Outcomes(p<0.01). From a longitudinal perspective, different levels of hospitals had different effects on the equity of Medical Outcomes(p<0.01). It was not the case that the higher the level of hospital, the better the medical outcome. When hospital levels and disease types were distinguished, the effect of hospitals of different levels on the medical outcome of different disease types was significantly different.Conclusions: COH made a difference in the equity of Medical Outcomes. Hospitals of different levels should be reasonably selected according to disease types to achieve the optimal medical outcome. Therefore, China should promote the construction of a tiered delivery system.

show abstract

Private or public hospital ownership: Does it really matter?

Cited by 23 publications

References 23 publications

Law and medical practice: A comparative vignette survey of cardiologists in Norway and Denmark

Law and medical practice: A comparative vignette survey of cardiologists in Norway and Denmark

Creating accountable hospital service areas in China: a case analysis of health expenditure in the metropolis of Chengdu

The Different Classification of Hospitals Impact on the Equity of Medical Outcomes of Patients in China

Contact Info

Product

Resources

About