IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0222204.html
   My bibliography  Save this article

Reasons behind stymied public hospital governance reform in China

Author

Listed:
  • Sheng Nong
  • Nengliang Aaron Yao

Abstract

Background: The public hospital governance reform in China is pledged to improve the governance of public hospitals and deliver affordable and high-quality care. However, progress in public hospital reform has been slow. The reason is poorly understood. Methods: A research center affiliated with China National Health Commission has conducted 32 workshops to interview 124 public hospital administrators from 30 provincial-level administrative divisions and 105 various-level government officials from three provinces. About 80% of administrators and 78% officials actively participated the discussions. We used a descriptive theoretical approach to understand the relationships between the governance reform and characteristics of its stakeholders. We also analyzed stakeholder interests and their power to influence the reform. Findings: About 66% of hospital administrators, 72% of health officials, and less than 10% of other officials support a new hospital governing structure. Local leadership, hospital administrators, and health commission said that administrators should have more power over the management of public hospitals. Other government departments and healthcare professionals had reservations on the governance reform. The reform of public hospital governance faces significant obstacles. The interests of most government stakeholders are not aligned with public interests. All stakeholders perceived that their workload would increase in the short term because of the governance reform of public hospitals. Most people involved in the reform are not incentivized to collaborate. The health commission has limited financial resources and insufficient political power to implement a massive reform. Most importantly, the public hospital reform is not, and likely will not be, a top policy priority to the central government or local leaderships. Interpretation: The health commission needs more political support and resources to speed up the public hospital reform. To fulfill the pledge of affordable, equitable access to quality care, Chinese government needs to overcome significant obstacles in the public hospital reform.

Suggested Citation

  • Sheng Nong & Nengliang Aaron Yao, 2019. "Reasons behind stymied public hospital governance reform in China," PLOS ONE, Public Library of Science, vol. 14(9), pages 1-11, September.
    • Handle: RePEc:plo:pone00:0222204
    DOI: 10.1371/journal.pone.0222204
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0222204
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0222204&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0222204?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
    ---><---

    References listed on IDEAS

    as
    1. Pan, Jay & Liu, Gordon G. & Gao, Chen, 2013. "How does separating government regulatory and operational control of public hospitals matter to healthcare supply?," China Economic Review, Elsevier, vol. 27(C), pages 1-14.
    2. Li Chang & Wenjing Li & Xiaoyan Lu, 2015. "Government Engagement, Environmental Policy, and Environmental Performance: Evidence from the Most Polluting Chinese Listed Firms," Business Strategy and the Environment, Wiley Blackwell, vol. 24(1), pages 1-19, January.
    3. Yuting Zhang & Qianheng Ma & Yingchun Chen & Hongxia Gao, 2017. "Effects of Public Hospital Reform on Inpatient Expenditures in Rural China," Health Economics, John Wiley & Sons, Ltd., vol. 26(4), pages 421-430, April.
    4. World Bank, 2010. "Fixing the Public Hospital System in China," World Bank Publications - Reports 27720, The World Bank Group.
    5. Song, Xiaoqian & Mu, Xiaoyi, 2013. "The safety regulation of small-scale coal mines in China: Analysing the interests and influences of stakeholders," Energy Policy, Elsevier, vol. 52(C), pages 472-481.
    Full references (including those not matched with items on IDEAS)

    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. 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. Yousaf, Umair Bin & Ullah, Irfan & Jiang, Junchen & Wang, Man, 2022. "The role of board capital in driving green innovation: Evidence from China," Journal of Behavioral and Experimental Finance, Elsevier, vol. 35(C).
    3. Li, Cunfang & Li, Danping & Zhang, Xiaoxu, 2019. "Why can China's coal resource-exhausted enterprises cross the district to transfer?," Resources Policy, Elsevier, vol. 60(C), pages 94-105.
    4. Yuxuan Li & Xin Miao & Dequan Zheng & Yanhong Tang, 2019. "Corporate Public Transparency on Financial Performance: The Moderating Role of Political Embeddedness," Sustainability, MDPI, vol. 11(19), pages 1-17, October.
    5. He, Yiqing & Ding, Xin & Yang, Chuchu, 2021. "Do environmental regulations and financial constraints stimulate corporate technological innovation? Evidence from China," Journal of Asian Economics, Elsevier, vol. 72(C).
    6. Yang, Qing & Zhang, Lei & Zhang, Jinsuo & Zou, Shaohui, 2021. "System simulation and policy optimization of China's coal production capacity deviation in terms of the economy, environment, and energy security," Resources Policy, Elsevier, vol. 74(C).
    7. Michael Yao-Ping Peng & Li Zhang & Meng-Hsiu Lee & Fang-Yih Hsu & Yan Xu & Yuan He, 2024. "The relationship between strategic human resource management, green innovation and environmental performance: a moderated-mediation model," Palgrave Communications, Palgrave Macmillan, vol. 11(1), pages 1-13, December.
    8. Shuai Han & Hong Chen & Maggie-Anne Harvey & Eric Stemn & David Cliff, 2018. "Focusing on Coal Workers’ Lung Diseases: A Comparative Analysis of China, Australia, and the United States," IJERPH, MDPI, vol. 15(11), pages 1-26, November.
    9. Liu, Lu & Zhao, Qiuhong & Bi, Yanlin, 2020. "Why rent-seeking behavior may exist in Chinese mining safety production inspection system and how to alleviate it: A tripartite game analysis," Resources Policy, Elsevier, vol. 69(C).
    10. Shuai Han & Hong Chen & Ruyin Long, 2020. "Who Reports Low Interactive Psychology Status? An Investigation Based on Chinese Coal Miners," IJERPH, MDPI, vol. 17(10), pages 1-20, May.
    11. Liu, Quanlong & Li, Xinchun & Hassall, Maureen, 2021. "Regulatory regime on coal Mine Safety in China and Australia: Comparative analysis and overall findings," Resources Policy, Elsevier, vol. 74(C).
    12. Chen, Sen-Sen & Xu, Jin-Hua & Fan, Ying, 2015. "Evaluating the effect of coal mine safety supervision system policy in China's coal mining industry: A two-phase analysis," Resources Policy, Elsevier, vol. 46(P2), pages 12-21.
    13. Liyong Lu & Jay Pan, 2021. "Does hospital competition lead to medical equipment expansion? Evidence on the medical arms race," Health Care Management Science, Springer, vol. 24(3), pages 582-596, September.
    14. Hu, Jun & Wu, Huiying & Ying, Sammy Xiaoyan, 2022. "Environmental regulation, market forces, and corporate environmental responsibility: Evidence from the implementation of cleaner production standards in China," Journal of Business Research, Elsevier, vol. 150(C), pages 606-622.
    15. Zhiliang Xu & Changxin Xu & Yun Li, 2023. "Green Credit Policy, Environmental Investment, and Green Innovation: Quasi-Natural Experimental Evidence from China," Sustainability, MDPI, vol. 15(10), pages 1-17, May.
    16. Ying Song & Lu Yang & Stavros Sindakis & Sakshi Aggarwal & Charles Chen, 2023. "Analyzing the Role of High-Tech Industrial Agglomeration in Green Transformation and Upgrading of Manufacturing Industry: the Case of China," Journal of the Knowledge Economy, Springer;Portland International Center for Management of Engineering and Technology (PICMET), vol. 14(4), pages 3847-3877, December.
    17. Liu, Quanlong & Wang, Jingzhi & Qiu, Zunxiang, 2023. "Data as evidence: Research on the influencing factors and mechanisms of coal mine safety supervision effect in China," Resources Policy, Elsevier, vol. 81(C).
    18. Lu, Liyong & Pan, Jay, 2019. "The association of hospital competition with inpatient costs of stroke: Evidence from China," Social Science & Medicine, Elsevier, vol. 230(C), pages 234-245.
    19. Tsambou André Dumas & Fomba Kamga Benjamin, 2023. "Adoption des Politiques de Protection de l'Environnement et performance des Entreprises Camerounaises," Canadian Journal of Agricultural Economics/Revue canadienne d'agroeconomie, Canadian Agricultural Economics Society/Societe canadienne d'agroeconomie, vol. 71(1), pages 89-117, March.
    20. See, Kok Fong & Ng, Ying Chu, 2021. "Do hospital reform and ownership matter to Shenzhen hospitals in China? A productivity analysis," Economic Analysis and Policy, Elsevier, vol. 72(C), pages 145-155.

    More about this item

    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:plo:pone00:0222204. 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: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    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.