IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i23p15507-d981203.html
   My bibliography  Save this article

The Response of Different-Levels Public Hospitals to Regional Global Budget with a Floating Payment System: Evidence from China

Author

Listed:
  • Li Xiang

    (School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China)

  • Zhengdong Zhong

    (School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China)

  • Junnan Jiang

    (School of Public Administration, Zhongnan University of Economics and Law, 182th South Lake Avenue, Wuhan 430073, China)

Abstract

Background: Regional Global Budget with a Floating Payment System (RGB-FPS) is a global budget widely used in medical insurance payments. However, existing studies on hospitals’ responses to RGB-FPS have limitations. First, existing studies have paid little attention to RGB-FPS’s macro effects. Theoretical studies did not analyze differences between different levels of hospitals. Secondly, studies did not reveal whether RGB-FPS has the same impact on the public-hospital-dominated market. Methods: First, we refine the research hypotheses through theoretical analysis. We then test the hypotheses empirically through interrupted time series analysis. Results: Theoretical analysis found that small hospitals were easier to transfer costs. The empirical analysis found that after RGB-FPS, the proportion of inpatients (PI)and the average times of inpatients in large hospitals increased ( p < 0.001), and the proportion of non-reimbursable expenses (PNE) remained stable ( p > 0.05). PI in secondary hospitals decreased ( p < 0.01), and PNE increased ( p < 0.01). PI in the primary hospital decreased ( p < 0.05), and PNE increased ( p < 0.001). Conclusion: This study verifies theoretically and empirically that large hospitals are easier to increase service volume and small hospitals are easier to transfer costs under the influence of RGB-FPS. Chinese public hospitals’ response to RGB-FPS is similar to that of private hospitals.

Suggested Citation

  • Li Xiang & Zhengdong Zhong & Junnan Jiang, 2022. "The Response of Different-Levels Public Hospitals to Regional Global Budget with a Floating Payment System: Evidence from China," IJERPH, MDPI, vol. 19(23), pages 1-11, November.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:23:p:15507-:d:981203
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/23/15507/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/19/23/15507/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Peter Martinsson & Emil Persson, 2019. "Physician behavior and conditional altruism: the effects of payment system and uncertain health benefit," Theory and Decision, Springer, vol. 87(3), pages 365-387, October.
    2. Breusch, T S, 1978. "Testing for Autocorrelation in Dynamic Linear Models," Australian Economic Papers, Wiley Blackwell, vol. 17(31), pages 334-355, December.
    3. Hung-pin Lai & Meng-Chi Tang, 2018. "Hospital efficiency under global budgeting: evidence from Taiwan," Empirical Economics, Springer, vol. 55(3), pages 937-963, November.
    4. Guanshen Dou & Yilin Zhang & Yunzhen He & Qiaoyun Huang & Yingfeng Ye & Xinyu Zhang & Weibing Wang & Xiaohua Ying, 2019. "Impact of the Global Budget Payment System on Expenditure of Cardiovascular Diseases: An Interrupted Time Series Analysis in Shanghai, China," IJERPH, MDPI, vol. 16(8), pages 1-14, April.
    5. Newey, Whitney & West, Kenneth, 2014. "A simple, positive semi-definite, heteroscedasticity and autocorrelation consistent covariance matrix," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 33(1), pages 125-132.
    6. Nicholas Barberis & Ming Huang, 2001. "Mental Accounting, Loss Aversion, and Individual Stock Returns," Journal of Finance, American Finance Association, vol. 56(4), pages 1247-1292, August.
    7. Benstetter, Franz & Wambach, Achim, 2006. "The treadmill effect in a fixed budget system," Journal of Health Economics, Elsevier, vol. 25(1), pages 146-169, January.
    8. Bradley Chen & Victoria Y. Fan, 2015. "Strategic Provider Behavior Under Global Budget Payment with Price Adjustment in Taiwan," Health Economics, John Wiley & Sons, Ltd., vol. 24(11), pages 1422-1436, November.
    9. Chang, Shun-Chiao & Lin, Chi-Feng & Yeh, Ta-Chun & Chang, Chun-Wei, 2019. "Determinants of the performance of traditional Chinese medicine clinics in Taiwan," Health Policy, Elsevier, vol. 123(4), pages 379-387.
    10. Haomiao Li & Yingchun Chen & Hongxia Gao & Jingjing Chang & Dai Su & Shihan Lei & Di Jiang & Xiaomei Hu & Min Tan & Zhifang Chen, 2019. "Effect of an Integrated Payment System on the Direct Economic Burden and Readmission of Rural Cerebral Infarction Inpatients: Evidence from Anhui, China," IJERPH, MDPI, vol. 16(9), pages 1-12, May.
    11. Nicholas Barberis & Ming Huang, 2001. "Mental Accounting, Loss Aversion, and Individual Stock Returns," NBER Working Papers 8190, National Bureau of Economic Research, Inc.
    12. Panagiotis Petrou, 2015. "An Interrupted Time-Series Analysis to Assess Impact of Introduction of Co-Payment on Emergency Room Visits in Cyprus," Applied Health Economics and Health Policy, Springer, vol. 13(5), pages 515-523, October.
    13. Godfrey, Leslie G, 1978. "Testing against General Autoregressive and Moving Average Error Models When the Regressors Include Lagged Dependent Variables," Econometrica, Econometric Society, vol. 46(6), pages 1293-1301, November.
    14. Birger Wernerfelt, 2013. "Small forces and large firms: Foundations of the RBV," Strategic Management Journal, Wiley Blackwell, vol. 34(6), pages 635-643, June.
    15. Cheng, Shou-Hsia & Chen, Chi-Chen & Chang, Wei-Ling, 2009. "Hospital response to a global budget program under universal health insurance in Taiwan," Health Policy, Elsevier, vol. 92(2-3), pages 158-164, October.
    16. Miaw-Chwen Lee & Andrew M. Jones, 2004. "How did Dentists Respond to the Introduction of Global Budgets in Taiwan? An Evaluation Using Individual Panel Data," International Journal of Health Economics and Management, Springer, vol. 4(4), pages 307-326, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Lin, Lee-Kai, 2022. "Effects of a global budget payment scheme on medical specialty workforces," Social Science & Medicine, Elsevier, vol. 309(C).
    2. Hung-pin Lai & Meng-Chi Tang, 2018. "Hospital efficiency under global budgeting: evidence from Taiwan," Empirical Economics, Springer, vol. 55(3), pages 937-963, November.
    3. David Hirshleifer & Danling Jiang, 2010. "A Financing-Based Misvaluation Factor and the Cross-Section of Expected Returns," The Review of Financial Studies, Society for Financial Studies, vol. 23(9), pages 3401-3436.
    4. repec:wyi:journl:002087 is not listed on IDEAS
    5. Eckhard Hein & Christian Schoder, 2011. "Interest rates, distribution and capital accumulation -- A post-Kaleckian perspective on the US and Germany," International Review of Applied Economics, Taylor & Francis Journals, vol. 25(6), pages 693-723, November.
    6. Braendle, Thomas & Colombier, Carsten, 2020. "Budgetary targets as cost-containment measure in the Swiss healthcare system? Lessons from abroad," Health Policy, Elsevier, vol. 124(6), pages 605-614.
    7. Russell Davidson & Victoria Zinde‐Walsh, 2017. "Advances in specification testing," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 50(5), pages 1595-1631, December.
    8. Carlsson, Mikael, 2000. "Measures of Technology and the Short-Run Responses to Technology Shocks - Is the RBC-Model Consistent with Swedish Manufacturing Data?," Working Paper Series 2000:20, Uppsala University, Department of Economics.
    9. Dragos Stefan Oprea & Elena Valentina Tilica, 2014. "Day-of-the-Week Effect in Post-Communist East European Stock Markets," International Journal of Academic Research in Accounting, Finance and Management Sciences, Human Resource Management Academic Research Society, International Journal of Academic Research in Accounting, Finance and Management Sciences, vol. 4(3), pages 119-129, July.
    10. Zhaobo Zhu & Wenjie Ding & Yi Jin & Dehua Shen, 2023. "Dissecting the Idiosyncratic Volatility Puzzle: A Fundamental Analysis Approach," Post-Print hal-04194180, HAL.
    11. Andrew Ang & Robert J. Hodrick & Yuhang Xing & Xiaoyan Zhang, 2006. "The Cross‐Section of Volatility and Expected Returns," Journal of Finance, American Finance Association, vol. 61(1), pages 259-299, February.
    12. Lai, Yi & Fu, Hongqiao & Li, Ling & Yip, Winnie, 2022. "Hospital response to a case-based payment scheme under regional global budget: The case of Guangzhou in China," Social Science & Medicine, Elsevier, vol. 292(C).
    13. Dragos Stefan Oprea & Laura Brad, 2014. "Investor Sentiment and Stock Returns: Evidence from Romania," International Journal of Academic Research in Accounting, Finance and Management Sciences, Human Resource Management Academic Research Society, International Journal of Academic Research in Accounting, Finance and Management Sciences, vol. 4(2), pages 19-25, April.
    14. Kent Daniel & David Hirshleifer & Lin Sun, 2020. "Short- and Long-Horizon Behavioral Factors," The Review of Financial Studies, Society for Financial Studies, vol. 33(4), pages 1673-1736.
    15. Wang, Huijun & Yan, Jinghua & Yu, Jianfeng, 2017. "Reference-dependent preferences and the risk–return trade-off," Journal of Financial Economics, Elsevier, vol. 123(2), pages 395-414.
    16. Scott Schuh, "undated". "Evidence on the Link between Firm-Level and Aggregate Inventory Behavior," Finance and Economics Discussion Series 1996-46, Board of Governors of the Federal Reserve System (U.S.), revised 10 Dec 2019.
    17. Li An & Huijun Wang & Jian Wang & Jianfeng Yu, 2020. "Lottery-Related Anomalies: The Role of Reference-Dependent Preferences," Management Science, INFORMS, vol. 66(1), pages 473-501, January.
    18. Schmidhammer, Christoph & Hille, Vanessa & Wiedemann, Arnd, 2020. "Performance of maturity transformation strategies," Discussion Papers 58/2020, Deutsche Bundesbank.
    19. Szőke, Tamás & Hortay, Olivér & Balogh, Eszter, 2019. "Asymmetric price transmission in the Hungarian retail electricity market," Energy Policy, Elsevier, vol. 133(C).
    20. Roberto Martínez-Espiñeira, 2007. "An Estimation of Residential Water Demand Using Co-Integration and Error Correction Techniques," Journal of Applied Economics, Taylor & Francis Journals, vol. 10(1), pages 161-184, May.
    21. Chabi-Yo, Fousseni & Ruenzi, Stefan & Weigert, Florian, 2018. "Crash Sensitivity and the Cross Section of Expected Stock Returns," Journal of Financial and Quantitative Analysis, Cambridge University Press, vol. 53(3), pages 1059-1100, June.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:23:p:15507-:d:981203. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.