Advanced Search
MyIDEAS: Login

Health Insurance Reform and Efficiency of Township Hospitals in Rural China: An Analysis from Survey Data

Contents:

Author Info

  • Xiao Xian HUANG

    ()

  • Aurore PELISSIER

    ()
    (Centre d'Etudes et de Recherches sur le Développement International)

  • Jacky MATHONNAT

    ()
    (Centre d'Etudes et de Recherches sur le Développement International)

  • Martine AUDIBERT

    ()
    (Centre d'Etudes et de Recherches sur le Développement International)

  • Anning MA

Abstract

In the rural health-care organization of China, township hospitals ensure the delivery of basic medical services. Particularly damaged by the economic reforms implemented from 1975 to the end of the 1990s, township hospitals efficiency is questioned, mainly with the implementation since 2003 of the reform of health insurance in rural areas. From a database of 24 randomly selected township hospitals observed over the period 2000-2008 in Weifang prefecture (Shandong), the study examines the efficiency of township hospitals through a two-stage approach. As curative and preventive medical services delivered at township hospital level use different production processes, two data envelopment analysis models are estimated with different orientation chosen to compute scores. Results show that technical efficiency declines over time. Factors explaining the technical efficiency are mainly environmental characteristics rather than internal factors, but our results suggest also that in the context of China, the efficiency of township hospitals is influenced by unobservable factors.

Download Info

If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
File URL: http://publi.cerdi.org/ed/2011/2011.11.pdf
Download Restriction: no

Bibliographic Info

Paper provided by CERDI in its series Working Papers with number 201111.

as in new window
Length: 25
Date of creation: 2011
Date of revision:
Handle: RePEc:cdi:wpaper:1257

Contact details of provider:
Postal: 65 Bd. F. Mitterrand, 63000 Clermont-Ferrand
Phone: (33-4) 73 17 74 00
Fax: (33-4) 73 17 74 28
Web page: http://cerdi.org/
More information through EDIRC

Related research

Keywords: China; New Rural Cooperative Medical Scheme; Technical efficiency; data envelopment analysis; Township Hospitals.;

Other versions of this item:

Find related papers by JEL classification:

This paper has been announced in the following NEP Reports:

References

References listed on IDEAS
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.:
as in new window
  1. Charnes, A. & Cooper, W. W. & Rhodes, E., 1978. "Measuring the efficiency of decision making units," European Journal of Operational Research, Elsevier, vol. 2(6), pages 429-444, November.
  2. János Kornai, 2009. "The soft budget constraint syndrome in the hospital sector," Society and Economy, Akadémiai Kiadó, Hungary, vol. 31(1), pages 5-31, June.
  3. Forsund, Finn R. & Lovell, C. A. Knox & Schmidt, Peter, 1980. "A survey of frontier production functions and of their relationship to efficiency measurement," Journal of Econometrics, Elsevier, vol. 13(1), pages 5-25, May.
  4. Martine Audibert & Yohana Dukhan & Jacky Mathonnat & Ningshan Chen & Aning Ma & Aïtian Yin, 2008. "Activité et performance des hôpitaux municipaux en Chine rurale. Une analyse sur données d'enquêtes dans la province de Shandong," Revue d’économie du développement, De Boeck Université, vol. 22(1), pages 63-100.
  5. Alexander S. Preker & April Harding, 2003. "Innovations in Health Service Delivery : The Corporatization of Public Hospitals," World Bank Publications, The World Bank, number 15145, October.
  6. Adam Wagstaff & Magnus Lindelow & Shiyong Wang & Shuo Zhang, 2009. "Reforming China's Rural Health System," World Bank Publications, The World Bank, number 2646, October.
  7. Zhang, Xuanchuan & Chen, Li-Wu & Mueller, Keith & Yu, Qiao & Liu, Jiapeng & Lin, Ge, 2011. "Tracking the effectiveness of health care reform in China: A case study of community health centers in a district of Beijing," Health Policy, Elsevier, vol. 100(2), pages 181-188.
  8. Wagstaff, Adam & Lindelow, Magnus & Jun, Gao & Ling, Xu & Juncheng, Qian, 2009. "Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme," Journal of Health Economics, Elsevier, vol. 28(1), pages 1-19, January.
  9. Ng, Ying Chu, 2011. "The productive efficiency of Chinese hospitals," China Economic Review, Elsevier, vol. 22(3), pages 428-439, September.
  10. Mark Duggan, 2000. "Hospital Ownership and Public Medical Spending," NBER Working Papers 7789, National Bureau of Economic Research, Inc.
  11. Boussofiane, A. & Dyson, R. G. & Thanassoulis, E., 1991. "Applied data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 52(1), pages 1-15, May.
  12. 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.
  13. Gerard M. La Forgia & Bernard F. Couttolenc, 2008. "Hospital Performance in Brazil : The Search for Excellence," World Bank Publications, The World Bank, number 6516, October.
  14. Gaynor, Martin, 2007. "Competition and Quality in Health Care Markets," Foundations and Trends(R) in Microeconomics, now publishers, vol. 2(6), pages 441-508, February.
  15. Tulkens, Henry, 1986. "La performance productive d’un service public. Définitions, méthodes de mesure et application à la Régie des Postes en Belgique," L'Actualité Economique, Société Canadienne de Science Economique, vol. 62(2), pages 306-335, juin.
  16. Gian Paolo Barbetta & Gilberto Turati & Angelo Zago, 2004. "Behavioral Differences Between Public and Private Not-For-Profit Hospitals in the Italian National Health Service," Working Papers 12, University of Verona, Department of Economics.
  17. Chen, Chi-Chen & Cheng, Shou-Hsia, 2010. "Hospital competition and patient-perceived quality of care: Evidence from a single-payer system in Taiwan," Health Policy, Elsevier, vol. 98(1), pages 65-73, November.
  18. Seiford, Lawrence M. & Thrall, Robert M., 1990. "Recent developments in DEA : The mathematical programming approach to frontier analysis," Journal of Econometrics, Elsevier, vol. 46(1-2), pages 7-38.
  19. Meltzer, David & Chung, Jeanette & Khalili, Parham & Marlow, Elizabeth & Arora, Vineet & Schumock, Glen & Burt, Ron, 2010. "Exploring the use of social network methods in designing healthcare quality improvement teams," Social Science & Medicine, Elsevier, vol. 71(6), pages 1119-1130, September.
  20. Jin Feng & Zheng Song, 2009. "Health care system in rural China: A quantitative approach based on heterogeneous individuals," Frontiers of Economics in China, Springer, vol. 4(2), pages 153-172, June.
  21. Jacobs,Rowena & Smith,Peter C. & Street,Andrew, 2006. "Measuring Efficiency in Health Care," Cambridge Books, Cambridge University Press, number 9780521851442, October.
  22. Yu-Chu Shen & Karen Eggleston, 2008. "The Effect of Soft Budget Constraints on Access and Quality in Hospital Care," NBER Working Papers 14256, National Bureau of Economic Research, Inc.
  23. Karen Eggleston & Yu-Chu Shen & Mingshan Lu & Congdong Li & Jian Wang & Zhe Yang & Jing Zhang, 2009. "Soft budget constraints in China: Evidence from the Guangdong hospital industry," International Journal of Health Care Finance and Economics, Springer, vol. 9(2), pages 233-242, June.
  24. Raymond L. Raab & Richard W. Lichty, 2002. "Identifying Subareas That Comprise A Greater Metropolitan Area: The Criterion of County Relative Efficiency," Journal of Regional Science, Wiley Blackwell, vol. 42(3), pages 579-594.
  25. Yan, Yu-Hua & Hsu, Shuofen & Yang, Chen-Wei & Fang, Shih-Chieh, 2010. "Agency problems in hospitals participating in self-management project under global budget system in Taiwan," Health Policy, Elsevier, vol. 94(2), pages 135-143, February.
  26. Leopold Simar & Paul Wilson, 2000. "A general methodology for bootstrapping in non-parametric frontier models," Journal of Applied Statistics, Taylor & Francis Journals, vol. 27(6), pages 779-802.
  27. Hu, Hsin-Hui & Qi, Qinghui & Yang, Chih-Hai, 2012. "Analysis of hospital technical efficiency in China: Effect of health insurance reform," China Economic Review, Elsevier, vol. 23(4), pages 865-877.
  28. Bruce Hollingsworth & P.J. Dawson & N. Maniadakis, 1999. "Efficiency measurement of health care: a review of non‐parametric methods and applications," Health Care Management Science, Springer, vol. 2(3), pages 161-172, July.
  29. Gerard M. La Forgia & Bernard F. Couttolenc, 2008. "Hospital Performance in Brazil : The Search For Excellence," World Bank Other Operational Studies 10284, The World Bank.
  30. O'Neill, Liam & Rauner, Marion & Heidenberger, Kurt & Kraus, Markus, 2008. "A cross-national comparison and taxonomy of DEA-based hospital efficiency studies," Socio-Economic Planning Sciences, Elsevier, vol. 42(3), pages 158-189, September.
  31. R. D. Banker & A. Charnes & W. W. Cooper, 1984. "Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis," Management Science, INFORMS, vol. 30(9), pages 1078-1092, September.
  32. Liu, Xingzhu & Xu, Lingzhong & Wang, Shuhong, 1996. "Reforming China's 50 000 township hospitals--effectiveness, challenges and opportunities," Health Policy, Elsevier, vol. 38(1), pages 13-29, October.
  33. Chang, Hsi-Hui, 1998. "Determinants of Hospital Efficiency: the Case of Central Government-owned Hospitals in Taiwan," Omega, Elsevier, vol. 26(2), pages 307-317, April.
  34. Annika Herr, 2008. "Cost and technical efficiency of German hospitals: does ownership matter?," Health Economics, John Wiley & Sons, Ltd., vol. 17(9), pages 1057-1071.
  35. Chang, Hsihui & Cheng, Mei-Ai & Das, Somnath, 2004. "Hospital ownership and operating efficiency: Evidence from Taiwan," European Journal of Operational Research, Elsevier, vol. 159(2), pages 513-527, December.
  36. Zhang, Xuanchuan & Chen, Li-Wu & Mueller, Keith & Yu, Qiao & Liu, Jiapeng & Lin, Ge, 2011. "Tracking the effectiveness of health care reform in China: A case study of community health centers in a district of Beijing," Health Policy, Elsevier, vol. 100(2-3), pages 181-188, May.
  37. Rajitkanok Puenpatom & Robert Rosenman, 2008. "Efficiency of Thai provincial public hospitals during the introduction of universal health coverage using capitation," Health Care Management Science, Springer, vol. 11(4), pages 319-338, December.
Full references (including those not matched with items on IDEAS)

Citations

Lists

This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

Statistics

Access and download statistics

Corrections

When requesting a correction, please mention this item's handle: RePEc:cdi:wpaper:1257. See general information about how to correct material in RePEc.

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Vincent Mazenod).

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 references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link 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 profile, as there may be some citations waiting for confirmation.

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