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Provider payment reform in China: the case of hospital reimbursement in Hainan province

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Author Info
Winnie Yip (Harvard School of Public Health, Cambridge, Massachusetts, USA)
Karen Eggleston (Tufts University, Medford, Massachusetts, USA)

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Abstract

This paper develops a simple model of payment incentives and empirically evaluates provider payment reform in Hainan Province, China. We use a pre-post study design with a control group to analyse two years of claims data to assess the impact of a January 1997 change to prospective payment for a sub-sample of the hospitals. This difference-in-difference empirical strategy allows us to isolate the supply-side payment reform effects from demand-side changes, in contrast with previous studies of China's reforms. Our results validate the theory that Chinese providers' behavioural response to payment incentives is similar to that reported in the literature derived from the experience of industrialized countries. We find that prepayment is associated with a slower rate of growth of overall expenditures, programme spending and patient co-payments per inpatient admission, compared to fee-for-service (FFS). These findings suggest cautious optimism regarding the effectiveness of prospective payment for controlling costs and should be encouraging for policymakers in developing and transitional economies considering replacement of FFS with more aggregated forms of provider payment. Copyright © 2001 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.602
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Publisher Info
Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 10 (2001)
Issue (Month): 4 ()
Pages: 325-339
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Handle: RePEc:wly:hlthec:v:10:y:2001:i:4:p:325-339

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Chalkley, Martin & Malcomson, James M., 1998. "Contracting for health services when patient demand does not reflect quality," Journal of Health Economics, Elsevier, vol. 17(1), pages 1-19, January. [Downloadable!] (restricted)
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  2. Ellis, Randall P & McGuire, Thomas G, 1993. "Supply-Side and Demand-Side Cost Sharing in Health Care," Journal of Economic Perspectives, American Economic Association, vol. 7(4), pages 135-51, Fall. [Downloadable!] (restricted)
  3. Martin L. Weitzman, 1980. "The "Ratchet Principle" and Performance Incentives," Bell Journal of Economics, The RAND Corporation, vol. 11(1), pages 302-308, Spring. [Downloadable!] (restricted)
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  4. Jonathan Gruber & Kathleen Adams & Joseph P. Newhouse, 1997. "Physician Fee Policy and Medicaid Program Costs," NBER Working Papers 6087, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  5. Gruber, Jonathan, 1994. "The Incidence of Mandated Maternity Benefits," American Economic Review, American Economic Association, vol. 84(3), pages 622-41, June. [Downloadable!] (restricted)
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Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. Karen Eggleston & Chee-Ruey Hsieh, 2004. "Health Care Payment Incentives: A Comparative Analysis of Reforms in Taiwan, Korea and China," Discussion Papers Series, Department of Economics, Tufts University 0402, Department of Economics, Tufts University. [Downloadable!]
  2. Biorn, Erik & Hagen, Terje P. & Iversen, Tor & Magnussen, Jon, 2002. "The Effect of Activity-Based Financing on Hospital Efficiency: A Panel Data Analysis of DEA Efficiency Scores 1992-2000," MPRA Paper 8099, University Library of Munich, Germany. [Downloadable!]
  3. Karen Eggleston & Keqin Rao & Jian Wang, 2005. "From Plan to Market in the Health Sector? China's Experience," Discussion Papers Series, Department of Economics, Tufts University 0501, Department of Economics, Tufts University. [Downloadable!]
  4. Ardeshir Sepehri & Sisira Sarma & Wayne Simpson, 2006. "Does non-profit health insurance reduce financial burden? Evidence from the Vietnam living standards survey panel," Health Economics, John Wiley & Sons, Ltd., vol. 15(6), pages 603-616. [Downloadable!]
  5. Karen Eggleston & Li Ling & Meng Qingyue & Magnus Lindelow & Adam Wagstaff, 2008. "Health service delivery in China: a literature review," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 149-165. [Downloadable!]
    Other versions:
  6. Karen Eggleston & Winnie Yip, 2004. "Hospital Competition under Regulated Prices: Application to Urban Health Sector Reforms in China," Discussion Papers Series, Department of Economics, Tufts University 0401, Department of Economics, Tufts University. [Downloadable!]
    Other versions:
  7. Likwang Chen & Winnie Yip & Ming-Cheng Chang & Hui-Sheng Lin & Shyh-Dye Lee & Ya-Ling Chiu & Yu-Hsuan Lin, 2007. "The effects of Taiwan's National Health Insurance on access and health status of the elderly," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 223-242. [Downloadable!]
  8. Jiale Zhang, 2007. "A DID analysis of the impact of health insurance reform in the city of Hangzhou," Health Economics, John Wiley & Sons, Ltd., vol. 16(12), pages 1389-1402. [Downloadable!]
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