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Hospital competition and patient-perceived quality of care: Evidence from a single-payer system in Taiwan

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  • Chen, Chi-Chen
  • Cheng, Shou-Hsia
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    Abstract

    Objectives To examine the effects of market competition on patient-perceived quality of care under a single-payer system in Taiwan.Methods Data came from two nationwide surveys conducted on discharged patients and National Health Insurance (NHI) hospital claim datasets in 2002 and 2004. Competition was measured by the Herfindahl-Hirschman Index (HHI). Quality of care was measured by patient-rated hospital performance including interpersonal skills and clinical competence domains. We used the instrumental variable approach to address the endogeneity between competition and patient-perceived quality of care.Results The results showed that HHI was significantly associated with a decrease in the perceived interpersonal skills (coefficient of -0.460; pÂ

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    Bibliographic Info

    Article provided by Elsevier in its journal Health Policy.

    Volume (Year): 98 (2010)
    Issue (Month): 1 (November)
    Pages: 65-73

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    Handle: RePEc:eee:hepoli:v:98:y:2010:i:1:p:65-73

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    Web page: http://www.elsevier.com/locate/healthpol

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    Keywords: Competition Perceived quality of care Hospital Taiwan;

    References

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    1. Annette Tomal, 1998. "The relationship between hospital mortality rates, and hospital, market and patient characteristics," Applied Economics, Taylor & Francis Journals, vol. 30(6), pages 717-725.
    2. Nazmi Sari, 2002. "Do competition and managed care improve quality?," Health Economics, John Wiley & Sons, Ltd., vol. 11(7), pages 571-584.
    3. David Meltzer & Jeanette Chung & Anirban Basu, 2002. "Does Competition under Medicare Prospective Payment Selectively Reduce Expenditures on High-Cost Patients?," RAND Journal of Economics, The RAND Corporation, vol. 33(3), pages 447-468, Autumn.
    4. José J. Escarce & Arvind K. Jain & Jeannette Rogowski, 2006. "Hospital Competition, Managed Care and Mortality After Hospitalization for Medical Conditions: Evidence From Three States," NBER Working Papers 12335, National Bureau of Economic Research, Inc.
    5. Daniel P. Kessler & Jeffrey J. Geppert, 2005. "The Effects of Competition on Variation in the Quality and Cost of Medical Care," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 14(3), pages 575-589, 09.
    6. Daniel P. Kessler & Mark B. McClellan, 2000. "Is Hospital Competition Socially Wasteful?," The Quarterly Journal of Economics, MIT Press, vol. 115(2), pages 577-615, May.
    7. Daniel P. Kessler & Jeffrey J. Geppert, 2005. "The Effects of Competition on Variation in the Quality and Cost of Medical Care," NBER Working Papers 11226, National Bureau of Economic Research, Inc.
    8. Zwanziger, Jack & Melnick, Glenn A., 1988. "The effects of hospital competition and the Medicare PPS program on hospital cost behavior in California," Journal of Health Economics, Elsevier, vol. 7(4), pages 301-320, December.
    9. Shen, Yu-Chu, 2003. "The effect of financial pressure on the quality of care in hospitals," Journal of Health Economics, Elsevier, vol. 22(2), pages 243-269, March.
    10. Ya-Ming Liu & Jean Kinsey, 2005. "The effect of competition on the practice of outpatient services for diabetes patients at different levels of hospitals in Taiwan," Applied Economics, Taylor & Francis Journals, vol. 37(12), pages 1411-1422.
    11. Patrick S. Romano & Ryan Mutter, 2004. "The Evolving Science of Quality Measurement for Hospitals: Implications for Studies of Competition and Consolidation," International Journal of Health Care Finance and Economics, Springer, vol. 4(2), pages 131-157, 06.
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    Cited by:
    1. Xiao Xian HUANG & Aurore PELISSIER & Jacky MATHONNAT & Martine AUDIBERT & Anning MA, 2011. "Health Insurance Reform and Efficiency of Township Hospitals in Rural China: An Analysis from Survey Data," Working Papers 201111, CERDI.
    2. Park, Sungchul & Lee, Jason & Ikai, Hiroshi & Otsubo, Tetsuya & Imanaka, Yuichi, 2013. "Decentralization and centralization of healthcare resources: Investigating the associations of hospital competition and number of cardiologists per hospital with mortality and resource utilization in ," Health Policy, Elsevier, vol. 113(1), pages 100-109.
    3. Schmid, Andreas & Ulrich, Volker, 2013. "Consolidation and concentration in the German hospital market: The two sides of the coin," Health Policy, Elsevier, vol. 109(3), pages 301-310.

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