Author
Listed:
- Daisheng Tang
- Zhen Zhang
- Xinyuan Wang
- Tao Bu
- Qiushi Feng
Abstract
Efforts to reform healthcare systems globally have long been driven by the inherent tradeoffs between equity and efficiency. Using a patient referral model, we constructed a cost– benefit matrix for both hospitals and patients. We analyzed the effects of nominal tiered diagnosis and treatment (TDT) using medical institutions' monthly report data from Sichuan province spanning 2012 to 2018. Additionally, we assessed the effects of actual TDT based on inpatient medical records data from Sichuan province spanning 2015 to 2018. We further discussed the potential for the TDT model to achieve Pareto improvements in addressing equity–efficiency trade‐offs in healthcare. Our findings suggest that nominal TDT failed to improve patients' medical behaviors. In contrast, actual TDT improved medical efficiency by enhancing patient outcomes and reducing the relative length of hospital stay, while also promoting medical equity by narrowing disparities in out‐of‐pocket expenses and health insurance reimbursements. Moreover, the effects of actual TDT on efficiency and equity varied across hospital types, disease categories, and inpatient populations. Actual TDT has the potential to generate Pareto improvements in managing the equity–efficiency trade‐offs within the healthcare system. Strengthening actual referral behaviors proved crucial for fully realizing the benefits of the TDT model.
Suggested Citation
Daisheng Tang & Zhen Zhang & Xinyuan Wang & Tao Bu & Qiushi Feng, 2025.
"Equity–Efficiency Trade‐offs in Healthcare System Reform: The Perspective of Tiered Diagnosis and Treatment in China,"
China & World Economy, Institute of World Economics and Politics, Chinese Academy of Social Sciences, vol. 33(3), pages 150-196, May.
Handle:
RePEc:bla:chinae:v:33:y:2025:i:3:p:150-196
DOI: 10.1111/cwe.12592
Download full text from publisher
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:bla:chinae:v:33:y:2025:i:3:p:150-196. 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.
We have no bibliographic references for this item. You can help adding them by using 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: Wiley Content Delivery (email available below). General contact details of provider: https://edirc.repec.org/data/iwepacn.html .
Please note that corrections may take a couple of weeks to filter through
the various RePEc services.