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Hospital competition and patient-perceived quality of care: Evidence from a single-payer system in Taiwan


  • Chen, Chi-Chen
  • Cheng, Shou-Hsia


Objectives To examine the effects of market competition on patient-perceived quality of care under a single-payer system in Taiwan.Methods Data came from two nationwide surveys conducted on discharged patients and National Health Insurance (NHI) hospital claim datasets in 2002 and 2004. Competition was measured by the Herfindahl-Hirschman Index (HHI). Quality of care was measured by patient-rated hospital performance including interpersonal skills and clinical competence domains. We used the instrumental variable approach to address the endogeneity between competition and patient-perceived quality of care.Results The results showed that HHI was significantly associated with a decrease in the perceived interpersonal skills (coefficient of -0.460; pÂ

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  • 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.
  • Handle: RePEc:eee:hepoli:v:98:y:2010:i:1:p:65-73

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    References listed on IDEAS

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    9. Nazmi Sari, 2002. "Do competition and managed care improve quality?," Health Economics, John Wiley & Sons, Ltd., vol. 11(7), pages 571-584.
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    Cited by:

    1. Pan, Jay & Qin, Xuezheng & Li, Qian & Messina, Joseph P. & Delamater, Paul L., 2015. "Does hospital competition improve health care delivery in China?," China Economic Review, Elsevier, vol. 33(C), pages 179-199.
    2. Audibert, Martine & Mathonnat, Jacky & Pelissier, Aurore & Huang, Xiao Xian & Ma, Anning, 2013. "Health insurance reform and efficiency of township hospitals in rural China: An analysis from survey data," China Economic Review, Elsevier, vol. 27(C), pages 326-338.
    3. Park, Sungchul & Lee, Jason & Ikai, Hiroshi & Otsubo, Tetsuya & Imanaka, Yuichi, 2013. "Decentralization and centralization of healthcare resources: Investigating the associations of hospital competition and number of cardiologists per hospital with mortality and resource utilization in ," Health Policy, Elsevier, vol. 113(1), pages 100-109.
    4. Schmid, Andreas & Ulrich, Volker, 2013. "Consolidation and concentration in the German hospital market: The two sides of the coin," Health Policy, Elsevier, vol. 109(3), pages 301-310.


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