IDEAS home Printed from https://ideas.repec.org/a/eee/chieco/v65y2021ics1043951x20301711.html
   My bibliography  Save this article

Misallocation and price distortions: A revenue decomposition of medical service providers in China

Author

Listed:
  • Deng, Zhongqi
  • Jiang, Nan
  • Song, Shunfeng
  • Pang, Ruizhi

Abstract

The provision of healthcare services and the distribution of medial resources across the China health system hierarchy is characterized by an inverted pyramid with alarming congestions in the so-called AAA tertiary hospitals. This study tries to investigate this baseline misallocation issue prior to the introduction of the new healthcare reforms in 2009. Building upon established framework, we developed an alternative measure for dispersion of factor price distortions. Using a large national microdata, the results obtained are consistent with previous studies in that for a less developed geographical market, often characterized by poorer factor mobility and weaker market competition, dispersion of the factor price distortions is high, reflecting high degree of misallocation. We also developed a decomposition of revenue dispersion to make inferences about the major channels through which the inverted pyramid arises. The analysis reveals the extent to which, the disproportionately large share of revenues generated by high-tier tertiary hospitals in China, can be attributed to their high productivity and the public trusts in them as providers of quality care.

Suggested Citation

  • Deng, Zhongqi & Jiang, Nan & Song, Shunfeng & Pang, Ruizhi, 2021. "Misallocation and price distortions: A revenue decomposition of medical service providers in China," China Economic Review, Elsevier, vol. 65(C).
    • Handle: RePEc:eee:chieco:v:65:y:2021:i:c:s1043951x20301711
    DOI: 10.1016/j.chieco.2020.101574
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S1043951X20301711
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.chieco.2020.101574?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Diego Restuccia & Richard Rogerson, 2008. "Policy Distortions and Aggregate Productivity with Heterogeneous Plants," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 11(4), pages 707-720, October.
    2. Jan De Loecker & Frederic Warzynski, 2012. "Markups and Firm-Level Export Status," American Economic Review, American Economic Association, vol. 102(6), pages 2437-2471, October.
    3. Diego Restuccia & Richard Rogerson, 2013. "Misallocation and productivity," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 16(1), pages 1-10, January.
    4. Jan De Loecker, 2011. "Product Differentiation, Multiproduct Firms, and Estimating the Impact of Trade Liberalization on Productivity," Econometrica, Econometric Society, vol. 79(5), pages 1407-1451, September.
    5. Jeannette Brosig‐Koch & Heike Hennig‐Schmidt & Nadja Kairies‐Schwarz & Daniel Wiesen, 2017. "The Effects of Introducing Mixed Payment Systems for Physicians: Experimental Evidence," Health Economics, John Wiley & Sons, Ltd., vol. 26(2), pages 243-262, February.
    6. John Asker & Allan Collard-Wexler & Jan De Loecker, 2019. "(Mis)Allocation, Market Power, and Global Oil Extraction," American Economic Review, American Economic Association, vol. 109(4), pages 1568-1615, April.
    7. Diego Restuccia & Richard Rogerson, 2017. "The Causes and Costs of Misallocation," Journal of Economic Perspectives, American Economic Association, vol. 31(3), pages 151-174, Summer.
    8. Amitabh Chandra & Amy Finkelstein & Adam Sacarny & Chad Syverson, 2016. "Health Care Exceptionalism? Performance and Allocation in the US Health Care Sector," American Economic Review, American Economic Association, vol. 106(8), pages 2110-2144, August.
    9. Bruce Hollingsworth, 2008. "The measurement of efficiency and productivity of health care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1107-1128, October.
    10. 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, February.
    11. Chang-Tai Hsieh & Peter J. Klenow, 2009. "Misallocation and Manufacturing TFP in China and India," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 124(4), pages 1403-1448.
    12. Xinyu Zhang & Lin Zhao & Zhuang Cui & Yaogang Wang, 2015. "Study on Equity and Efficiency of Health Resources and Services Based on Key Indicators in China," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-15, December.
    13. Lucia S. Foster & Cheryl A. Grim & John Haltiwanger & Zoltan Wolf, 2017. "Macro and Micro Dynamics of Productivity: From Devilish Details to Insights," NBER Working Papers 23666, National Bureau of Economic Research, Inc.
    14. Lucia Foster & John Haltiwanger & Chad Syverson, 2008. "Reallocation, Firm Turnover, and Efficiency: Selection on Productivity or Profitability?," American Economic Review, American Economic Association, vol. 98(1), pages 394-425, March.
    15. G. Jacob Blackwood & Lucia S. Foster & Cheryl A. Grim & John Haltiwanger & Zoltan Wolf, 2021. "Macro and Micro Dynamics of Productivity: From Devilish Details to Insights," American Economic Journal: Macroeconomics, American Economic Association, vol. 13(3), pages 142-172, July.
    16. Kumbhakar,Subal C. & Wang,Hung-Jen & Horncastle,Alan P., 2015. "A Practitioner's Guide to Stochastic Frontier Analysis Using Stata," Cambridge Books, Cambridge University Press, number 9781107029514.
    17. Jing Sun & Jing Ma & Guangyu Hu & Qi Zhao & Changzheng Yuan & Wen Si & Xinqing Zhang & Yuanli Liu, 2017. "Welfare, wellness, and job satisfaction of Chinese physicians: A national survey of public tertiary hospitals in China," International Journal of Health Planning and Management, Wiley Blackwell, vol. 32(3), pages 270-284, July.
    18. Hugo A. Hopenhayn, 2014. "Firms, Misallocation, and Aggregate Productivity: A Review," Annual Review of Economics, Annual Reviews, vol. 6(1), pages 735-770, August.
    19. Minmin Li & Biao He & Renzhong Guo & You Li & Yu Chen & Yong Fan, 2018. "Study on Population Distribution Pattern at the County Level of China," Sustainability, MDPI, vol. 10(10), pages 1-16, October.
    20. Pengqian Fang & Ruirong Hu & Qiuxia Han, 2017. "Effects of healthcare reform on health resource allocation and service utilization in 1110 Chinese county hospitals: data from 2006 to 2012," International Journal of Health Planning and Management, Wiley Blackwell, vol. 32(4), pages 400-415, October.
    21. Lucia Foster & Cheryl Grim & John Haltiwanger & Zoltan Wolf, 2016. "Firm-Level Dispersion in Productivity: Is the Devil in the Details?," American Economic Review, American Economic Association, vol. 106(5), pages 95-98, May.
    22. Keser, Claudia & Schnitzler, Cornelius, 2013. "Money talks: Paying physicians for performance," University of Göttingen Working Papers in Economics 173, University of Goettingen, Department of Economics.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Juan Tang & Fangming Qin, 2022. "Analyzing the impact of local government competition on green total factor productivity from the factor market distortion perspective: based on the three stage DEA model," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 24(12), pages 14298-14326, December.
    2. Ling-Yun He & Sha Liu, 2023. "Impact of China Railway Express on Regional Resource Mismatch—Empirical Evidence from China," Sustainability, MDPI, vol. 15(11), pages 1-17, May.

    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. Simone Lenzu & Francesco Manaresi, 2019. "Sources and implications of resource misallocation: new evidence from firm-level marginal products and user costs," Questioni di Economia e Finanza (Occasional Papers) 485, Bank of Italy, Economic Research and International Relations Area.
    2. Lenzu, Simone & Manaresi, Francesco, 2018. "Do Marginal Products Differ from User Costs? Micro-Level Evidence from Italian Firms," Working Papers 276, The University of Chicago Booth School of Business, George J. Stigler Center for the Study of the Economy and the State.
    3. Alpysbayeva, Dinara & Vanormelingen, Stijn, 2022. "Labor market rigidities and misallocation: Evidence from a natural experiment," Labour Economics, Elsevier, vol. 78(C).
    4. Wu, Yan & Heerink, Nico & Yu, Linhui, 2020. "Real estate boom and resource misallocation in manufacturing industries: Evidence from China," China Economic Review, Elsevier, vol. 60(C).
    5. Da-Rocha, José-María & Restuccia, Diego & Tavares, Marina Mendes, 2019. "Firing costs, misallocation, and aggregate productivity," Journal of Economic Dynamics and Control, Elsevier, vol. 98(C), pages 60-81.
    6. Bento, Pedro & Restuccia, Diego, 2021. "On average establishment size across sectors and countries," Journal of Monetary Economics, Elsevier, vol. 117(C), pages 220-242.
    7. Dobbelaere, Sabien & Kiyota, Kozo & Mairesse, Jacques, 2015. "Product and labor market imperfections and scale economies: Micro-evidence on France, Japan and the Netherlands," Journal of Comparative Economics, Elsevier, vol. 43(2), pages 290-322.
    8. Chaoran Chen & Diego Restuccia & Raül Santaeulàlia-Llopis, 2023. "Land Misallocation and Productivity," American Economic Journal: Macroeconomics, American Economic Association, vol. 15(2), pages 441-465, April.
    9. Diego Restuccia, 2019. "Misallocation and aggregate productivity across time and space," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 52(1), pages 5-32, February.
    10. Douglas Gollin & Christopher Udry, 2021. "Heterogeneity, Measurement Error, and Misallocation: Evidence from African Agriculture," Journal of Political Economy, University of Chicago Press, vol. 129(1), pages 1-80.
    11. Diego Restuccia & Richard Rogerson, 2017. "The Causes and Costs of Misallocation," Journal of Economic Perspectives, American Economic Association, vol. 31(3), pages 151-174, Summer.
    12. Correa, Juan A. & Gómez, Marcos & Luengo, Andrés & Parro, Francisco, 2021. "Environmental misallocation in the copper industry," Resources Policy, Elsevier, vol. 71(C).
    13. Laiqun Jin & Changwei Mo & Bochao Zhang & Bing Yu, 2018. "What Is the Focus of Structural Reform in China?—Comparison of the Factor Misallocation Degree within the Manufacturing Industry with a Unified Model," Sustainability, MDPI, vol. 10(11), pages 1-19, November.
    14. Tasso Adamopoulos & Diego Restuccia, 2020. "Land Reform and Productivity: A Quantitative Analysis with Micro Data," American Economic Journal: Macroeconomics, American Economic Association, vol. 12(3), pages 1-39, July.
    15. Nicholas Bloom & Erik Brynjolfsson & Lucia Foster & Ron Jarmin & Megha Patnaik & Itay Saporta-Eksten & John Van Reenen, 2019. "What Drives Differences in Management Practices?," American Economic Review, American Economic Association, vol. 109(5), pages 1648-1683, May.
    16. Li, Kun & Azacis, Helmuts & Luintel, Kul B, 2023. "Resource Misallocation in the Presence of R&D Spillovers," Cardiff Economics Working Papers E2023/24, Cardiff University, Cardiff Business School, Economics Section.
    17. Lucia S. Foster & Cheryl A. Grim & John Haltiwanger & Zoltan Wolf, 2017. "Macro and Micro Dynamics of Productivity: From Devilish Details to Insights," NBER Working Papers 23666, National Bureau of Economic Research, Inc.
    18. G. Jacob Blackwood & Lucia S. Foster & Cheryl A. Grim & John Haltiwanger & Zoltan Wolf, 2021. "Macro and Micro Dynamics of Productivity: From Devilish Details to Insights," American Economic Journal: Macroeconomics, American Economic Association, vol. 13(3), pages 142-172, July.
    19. Hu, Zhongzhong & Rodrigue, Joel & Tan, Yong & Yu, Chunhai, 2017. "Product churning, reallocation, and Chinese export growth," Journal of Economic Behavior & Organization, Elsevier, vol. 143(C), pages 147-164.
    20. van der Geest, Jesse, 2024. "Economic effects of tax avoidance and compliance," Other publications TiSEM aaca33bf-975d-4e21-9b5f-5, Tilburg University, School of Economics and Management.

    More about this item

    Keywords

    China healthcare; Misallocation; Factor price distortion; Revenue decomposition;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • D61 - Microeconomics - - Welfare Economics - - - Allocative Efficiency; Cost-Benefit Analysis
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • P36 - Political Economy and Comparative Economic Systems - - Socialist Institutions and Their Transitions - - - Consumer Economics; Health; Education and Training; Welfare, Income, Wealth, and Poverty

    Statistics

    Access and download statistics

    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:eee:chieco:v:65:y:2021:i:c:s1043951x20301711. 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: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/chieco .

    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.