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Hospital ownership and performance: Evidence from stroke and cardiac treatment in Taiwan

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  • Lien, Hsien-Ming
  • Chou, Shin-Yi
  • Liu, Jin-Tan

Abstract

This paper compares program expenditure and treatment quality of stroke and cardiac patients between 1997 and 2000 across hospitals of various ownership types in Taiwan. Because Taiwan implemented national health insurance in 1995, the analysis is immune from problems arising from the complex setting of the U.S. health care market, such as segmentation of insurance status or multiple payers. Because patients may select admitted hospitals based on their observed and unobserved characteristics, we employ instrument variable (IV) estimation to account for the endogeneity of ownership status. Results of IV estimation find that patients admitted to non-profit hospitals receive better quality care, either measured by 1- or 12-month mortality rates. In terms of treatment expenditure, our results indicate no difference between non-profits and for-profits index admission expenditures, and at most 10% higher long-term expenditure for patients admitted to non-profits than to for-profits.

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Bibliographic Info

Article provided by Elsevier in its journal Journal of Health Economics.

Volume (Year): 27 (2008)
Issue (Month): 5 (September)
Pages: 1208-1223

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Handle: RePEc:eee:jhecon:v:27:y:2008:i:5:p:1208-1223

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Web page: http://www.elsevier.com/locate/inca/505560

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References

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  1. Edward L. Glaeser & Andrei Shleifer, 1998. "Not-For-Profit Entrepreneurs," Harvard Institute of Economic Research Working Papers 1852, Harvard - Institute of Economic Research.
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  8. Anup Malani & Tomas Philipson & Guy David, 2003. "Theories of Firm Behavior in the Nonprofit Sector. A Synthesis and Empirical Evaluation," NBER Chapters, in: The Governance of Not-for-Profit Organizations, pages 181-216 National Bureau of Economic Research, Inc.
  9. Ettner, Susan L. & Hermann, Richard C., 2001. "The role of profit status under imperfect information: evidence from the treatment patterns of elderly Medicare beneficiaries hospitalized for psychiatric diagnoses," Journal of Health Economics, Elsevier, vol. 20(1), pages 23-49, January.
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Citations

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Cited by:
  1. Dormont, Brigitte & Milcent, Carine, 2013. "Comment évaluer la productivité et l’efficacité des hôpitaux publics et privés ? Les enjeux de la convergence tarifaire," Economics Papers from University Paris Dauphine 123456789/7738, Paris Dauphine University.
  2. Carine Milcent & Brigitte Dormont, 2012. "Comment évaluer la productivité et l'efficacité des hôpitaux publics et privés ? Les enjeux de la convergence tarifaire," Économie et Statistique, Programme National Persée, vol. 455(1), pages 143-173.
  3. Laurent Gobillon & Carine Milcent, 2013. "Spatial disparities in hospital performance," PSE - Labex "OSE-Ouvrir la Science Economique" halshs-00879787, HAL.
  4. Clark, Andrew E. & Milcent, Carine, 2011. "Public employment and political pressure: The case of French hospitals," Journal of Health Economics, Elsevier, vol. 30(5), pages 1103-1112.
  5. Dormont, Brigitte & Milcent, Carine, 2012. "Ownership and Hospital Productivity," Economics Papers from University Paris Dauphine 123456789/12066, Paris Dauphine University.
  6. Brekke, Kurt R. & Siciliani, Luigi & Straume, Odd Rune, 2012. "Quality competition with profit constraints," Journal of Economic Behavior & Organization, Elsevier, vol. 84(2), pages 642-659.
  7. Laurent Gobillon & Carine Milcent, 2011. "Innovative procedures: the key factor for hospital performance," PSE Working Papers halshs-00653441, HAL.
  8. Brekke, Kurt R. & Siciliani, Luigi & Straume, Odd Rune, 2011. "Quality competition with profit constraints: Do non-profit firms provide higher quality than for-profit firms?," Discussion Paper Series in Economics 2/2011, Department of Economics, Norwegian School of Economics.
  9. Gobillon, Laurent & Milcent, Carine, 2013. "Evaluating the effect of ownership status on hospital quality: the key role of innovative procedures," CEPR Discussion Papers 9272, C.E.P.R. Discussion Papers.
  10. Xavier Fageda & Eva Fiz, 2010. "Ownership, Incentives and Hospitals," IREA Working Papers 201012, University of Barcelona, Research Institute of Applied Economics, revised Sep 2010.
  11. Pérotin, Virginie & Zamora, Bernarda & Reeves, Rachel & Bartlett, Will & Allen, Pauline, 2013. "Does hospital ownership affect patient experience? An investigation into public–private sector differences in England," Journal of Health Economics, Elsevier, vol. 32(3), pages 633-646.
  12. repec:hal:wpaper:halshs-00653441 is not listed on IDEAS

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