Comparing public and private emergency departments in China: Early evidence from a national healthcare quality survey

Abstract

Summary The number of private healthcare facilities has rapidly increased since the progressive open market policies, which began in the 1980s; however, little is known about the development of private emergency departments (EDs). This cross‐sectional study was part of the National Control Information System (NCIS) project, which collects data annually from hospitals across China. Emergency services data were extracted and included location, infrastructure, human resources, beds, and number of patients; 4529 hospitals across 31 provinces in mainland China were eventually included, consisting of 988 private and 3541 public EDs. Evidence shows that most private EDs are located in central China, where local economies are relatively developed. Most private EDs (91.6%) are found in secondary hospitals but have significantly fewer beds and smaller workforces compared with public EDs. An imbalance of emergency medical resources was observed across China, and this disparity becomes even more profound in rural hospitals. These findings may initiate collaborative, public‐private partnerships in emergency health services provision and suggest there is a need to offer tax breaks to incentivize investors, but further research is required. We may also need to rethink health insurance policies, which could enable more equitable access to private emergency care. Future planning and health policies must be based upon the strongest available evidence, if we are to address imbalanced health services distribution and growing demand.

Healthcare preferences of the general Chinese population in the hierarchical medical system: A discrete choice experiment

“…People are more willing to receive treatment in general hospitals funded by the government, where they can receive in-patient management and benefit from a high-quality referral system. Besides, most private hospitals are located in developed areas ( 48 ), so people in rural areas may not be familiar with these hospitals. However, scholars have found that although the number of employees in some private hospitals is less than in public hospitals, the level of vocational qualification certificates is higher than that of public hospital employees ( 49 ).…”

“…Moreover, according to previous studies, the quality of medical services is not directly related to the type of ownership ( 50 ), since no statistical difference was found in the mortality rates between general hospitals and private hospitals of the same scale. In this case, many researchers have advocated the health policy to enable more equitable access to private care ( 48 , 51 ). In addition to community hospitals, private hospitals may also become medical facilities for sharing patients in tertiary hospitals, which is worth considering by the government.…”

Incidence of Medical Malpractice Lawsuits and Its Relationship to the Growth of Private Hospitals

“…Though public hospitals dominate the health care market in China, greater private hospitals expansion contributes to a competitive hospital market. Second, in regions with more private hospitals, such as in Eastern China (40.4%) [15]and relatively developed areas [40,41] , it would be preferred to use alternative methods to solve medical disputes rather than litigation. Alternative methods for solving medical disputes include negotiation, people's mediation, administrative mediation, litigation, and other legal routes [42].…”

Compassion fatigue among haemodialysis nurses in public and private hospitals in China

“…Therefore, in total, of 300 questionnaires sent out, 150 were distributed to public hospitals and 150 to private hospitals. Hospitals in China are classified according to a three‐level system (Jin et al, 2019) as primary, secondary, or tertiary institutions. Primary hospitals provide only minimal medical services and do not usually have HD centres; therefore, to avoid confounding effects from the considerable differences in social development across China, only secondary and tertiary hospitals with HD centres were included.…”

“…The number of private health care facilities has rapidly increased since the implementation of progressive open market policies in China (Jin et al, 2019; Tang et al, 2014), and a large number of haemodialysis centres and independent dialysis rooms have been established. Many countries and regions have adopted these two systems for HD treatment (Chen et al, 2016; de Filippis et al, 2007; Gowda et al, 2017; Gray et al, 2012; Rottembourg & Rostoker, 2018).…”