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Hospital ownership and performance: Evidence from stroke and cardiac treatment in Taiwan

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  • Lien, Hsien-Ming
  • Chou, Shin-Yi
  • Liu, Jin-Tan

Abstract

This paper compares program expenditure and treatment quality of stroke and cardiac patients between 1997 and 2000 across hospitals of various ownership types in Taiwan. Because Taiwan implemented national health insurance in 1995, the analysis is immune from problems arising from the complex setting of the U.S. health care market, such as segmentation of insurance status or multiple payers. Because patients may select admitted hospitals based on their observed and unobserved characteristics, we employ instrument variable (IV) estimation to account for the endogeneity of ownership status. Results of IV estimation find that patients admitted to non-profit hospitals receive better quality care, either measured by 1- or 12-month mortality rates. In terms of treatment expenditure, our results indicate no difference between non-profits and for-profits index admission expenditures, and at most 10% higher long-term expenditure for patients admitted to non-profits than to for-profits.

Suggested Citation

  • Lien, Hsien-Ming & Chou, Shin-Yi & Liu, Jin-Tan, 2008. "Hospital ownership and performance: Evidence from stroke and cardiac treatment in Taiwan," Journal of Health Economics, Elsevier, vol. 27(5), pages 1208-1223, September.
  • Handle: RePEc:eee:jhecon:v:27:y:2008:i:5:p:1208-1223
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    1. repec:dau:papers:123456789/12066 is not listed on IDEAS
    2. Laurent Gobillon & Carine Milcent, 2013. "Spatial disparities in hospital performance," Journal of Economic Geography, Oxford University Press, vol. 13(6), pages 1013-1040, November.
    3. Xavier Fageda & Eva Fiz, 2010. "Ownership, Incentives and Hospitals," IREA Working Papers 201012, University of Barcelona, Research Institute of Applied Economics, revised Sep 2010.
    4. Barigozzi, Francesca & Burani, Nadia, 2016. "Competition and screening with motivated health professionals," Journal of Health Economics, Elsevier, vol. 50(C), pages 358-371.
    5. Laurent Gobillon & Carine Milcent, 2011. "Innovative procedures: the key factor for hospital performance," Working Papers halshs-00653441, HAL.
    6. Tzu-Ting Yang & Hsing-Wen Han & Hsien-Ming Lien, 2014. "Patient Cost-Sharing and Healthcare Utilization in Early Childhood: Evidence from a Regression Discontinuity Design," Working Papers 14C003, Canadian Centre for Health Economics.
    7. Pérotin, Virginie & Zamora, Bernarda & Reeves, Rachel & Bartlett, Will & Allen, Pauline, 2013. "Does hospital ownership affect patient experience? An investigation into public–private sector differences in England," Journal of Health Economics, Elsevier, vol. 32(3), pages 633-646.
    8. Clark, Andrew E. & Milcent, Carine, 2011. "Public employment and political pressure: The case of French hospitals," Journal of Health Economics, Elsevier, vol. 30(5), pages 1103-1112.
    9. Laurent Gobillon & Carine Milcent, 2016. "Evaluating the Effect of Ownership Status on Hospital Quality: The Key Role of Innovative Procedures," Annals of Economics and Statistics, GENES, issue 121-122, pages 161-186.
    10. Magdalena A. Stroka, 2016. "Drug overprescription in nursing homes: an empirical evaluation of administrative data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(3), pages 257-267, April.
    11. Kamhon Kan & Shu-Fen Li & Wei-Der Tsai, 2014. "The impact of global budgeting on treatment intensity and outcomes," International Journal of Health Economics and Management, Springer, vol. 14(4), pages 311-337, December.
    12. Kurt R. Brekke & Luigi Siciliani & Odd Rune Straume, 2011. "Quality competition with profit constraints: Do non-profit firms provide higher quality than for-profit firms?," NIPE Working Papers 05/2011, NIPE - Universidade do Minho.
    13. Brigitte Dormont & Carine Milcent, 2012. "Comment évaluer la productivité et l'efficacité des hôpitaux publics et privés ? Les enjeux de la convergence tarifaire," Économie et Statistique, Programme National Persée, vol. 455(1), pages 143-173.
    14. Luigi Siciliani & Peter Sivey & Andrew Street, 2011. "Differences in Length of Stay between Public Hospitals, Treatment Centres and Private Providers: Selection or Efficiency?," Melbourne Institute Working Paper Series wp2011n06, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne.
    15. Laurent Gobillon & Carine Milcent, 2010. "Innovative Procedures : The Key Factor for Hospital Performance," Working Papers 2010-14, Center for Research in Economics and Statistics.
    16. Brekke, Kurt R. & Siciliani, Luigi & Straume, Odd Rune, 2012. "Quality competition with profit constraints," Journal of Economic Behavior & Organization, Elsevier, vol. 84(2), pages 642-659.
    17. Huang, Nicole & Chou, Yiing-Jenq & Hu, Hsiao-Yun & Lee, Cheng-Hua, 2013. "Gender disparities in AMI management and outcomes among health professionals, their relatives, and non-health professionals in Taiwan from 1997 to 2007," Social Science & Medicine, Elsevier, vol. 77(C), pages 70-74.
    18. repec:dau:papers:123456789/7738 is not listed on IDEAS

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