Comparing Public and Private Hospitals in China: Evidence from Guangdong

Eggleston, Karen; Lu, Mingshan; Li, Congdong; Wang, Jian; Liu, Danhong; Zhang, Jing

doi:10.2139/ssrn.1658157

Cited by 6 publications

(5 citation statements)

References 18 publications

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“…Higher cooperative medical system coverage rates are associated with higher occupancy rates, suggesting that expanding insurance coverage to China's rural majority increases utilization of inpatient resources. All results and their associated statistical tests are available in the working paper [ 18 ].…”

Section: Resultsmentioning

confidence: 99%

Comparing public and private hospitals in China: Evidence from Guangdong

Eggleston

et al. 2010

BMC Health Serv Res

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BackgroundThe literature comparing private not-for-profit, for-profit, and government providers mostly relies on empirical evidence from high-income and established market economies. Studies from developing and transitional economies remain scarce, especially regarding patient case-mix and quality of care in public and private hospitals, even though countries such as China have expanded a mixed-ownership approach to service delivery. The purpose of this study is to compare the operations and performance of public and private hospitals in Guangdong Province, China, focusing on differences in patient case-mix and quality of care.MethodsWe analyze survey data collected from 362 government-owned and private hospitals in Guangdong Province in 2005, combining mandatorily reported administrative data with a survey instrument designed for this study. We use univariate and multi-variate regression analyses to compare hospital characteristics and to identify factors associated with simple measures of structural quality and patient outcomes.ResultsCompared to private hospitals, government hospitals have a higher average value of total assets, more pieces of expensive medical equipment, more employees, and more physicians (controlling for hospital beds, urban location, insurance network, and university affiliation). Government and for-profit private hospitals do not statistically differ in total staffing, although for-profits have proportionally more support staff and fewer medical professionals. Mortality rates for non-government non-profit and for-profit hospitals do not statistically differ from those of government hospitals of similar size, accreditation level, and patient mix.ConclusionsIn combination with other evidence on health service delivery in China, our results suggest that changes in ownership type alone are unlikely to dramatically improve or harm overall quality. System incentives need to be designed to reward desired hospital performance and protect vulnerable patients, regardless of hospital ownership type.

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Section: Resultsmentioning

confidence: 99%

Comparing public and private hospitals in China: Evidence from Guangdong

Eggleston

et al. 2010

BMC Health Serv Res

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“…Also we found that most of the malpractice cases occurred in public hospitals rather than private ones. Perhaps the immaturity of market-oriented allocation of medical resources during the reform of medical care system may help explaining and understanding this phenomenon (22,23).…”

Section: Discussionmentioning

confidence: 99%

Medical Malpractice Litigation Following Spine Surgery in Beijing: The Past 6 Years.

Liu

et al. 2020

Preprint

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Background: Spine surgeons in particular face the most hostile liability environment among the surgical specialties. Systemic studies related to spine surgery litigation in China is absent. The aim of this study was to analyze the characteristics of medical malpractice litigation involving spine surgery in Beijing for the past 6 years.Methods: Two online legal databases, Wusong and Weike, were queried for court verdicts involving spine surgery from Jan 2013 to Dec 2018 in Beijing. For all included cases, data pertaining to defendants, plaintiffs, case outcomes, allegations, and verdicts were abstracted, and descriptive analyses were performed. Results: A total of 186 legal cases were examined, 122 cases were excluded due to irrelevance or insufficient information. Of the 64 cases included in this investigation, 40.6% of them were male. The mean age of the plaintiffs was 53.2 ± 18.6 years. The most common complaint addressed in this study is dissatisfaction with consent (53.1%, n=34), followed by additional surgery required (40.2%, n=26), unsatisfactory outcome to surgery (17.6%, n=11), postoperative paralysis (15.6%, n=10) and postoperative infection (15.6%, n=10). The most common primary disease among all the cases is lumbar spinal stenosis (28.1%, n=18), followed by spinal tumor (18.8%, n=12), cervical spondylosis (17.2%, n=11), vertebral fracture (14.1%, n=9), deformity (12.5%, n=8) and others (9.3%, n=6). Spine surgeons successfully defended themselves in 13 cases (20.3%), which resulted in no indemnity payment. The rest 51 cases (79.7%) were closed with an average verdict payout of 155,562 Yuan, which was significant lower than the average compensation claimed by the plaintiff (783,172 Yuan) (p < 0.05). Conclusions: Identifying the most common reasons for litigation and summarizing their characteristics may help decrease litigation rate and improve the patient experience. Further investigations with larger sample size and more complete database are needed.

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“…This research, an observation on conflict and resolution over doctors' pay, has shed new light on documenting medical doctors' discontents and accommodation in contemporary Chinese health services. Insufficient public investment and market-oriented strategy are part of China's controversial health reform (Bloom et al, 2001;Lim et al, 2004;Eggleston et al, 2010;Cao, 2011;Reynolds and McKee, 2011), and the commercialization has intensified the conflict between doctors and their employers. The study brings a closer attention to the largely ignored health professionals whose pay is heavily shadowed by the marketization reform in recent decades.…”

Section: Discussionmentioning

confidence: 99%

“…This has forced hospital management to allocate medical resources with greater reliance on market environment, and maintain qualified service despite the declining government funding (Pei et al, 2000: 104). For example, a survey found that in 2009, 40% to 50% of Chinese hospitals' revenue came from drug sales (Eggleston et al, 2010). As a result of the marketization, hospitals' payment systems have been changing.…”

Section: Managing Human Resources In China's Public Health Servicesmentioning

confidence: 99%

Submerged discontent and patterns of accommodation: a case study of doctors' pay in two public hospitals in China

Cao

2013

Health Planning & Management

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The article evaluates submerged discontent among Chinese public hospital doctors (Note1) regarding their pay and patterns of accommodation, including doctors' responses through formal and informal actions in the context of health service marketization. On the basis of a case study of two public hospitals, the article illustrates the dynamical impact of marketization on Chinese doctors' pay-related dissatisfaction and health service employment relationship. Because of the authoritarian management and compliant trade unions, the conflict between doctors and hospitals is unable to be accommodated through collective methods. Instead, doctors' discontent is often channelled through informal, individual and subtle activities. Meanwhile, doctors' professional society is gradually influential, showing its potential of developing doctors' group identity and protecting members' interests in future.

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Comparing Public and Private Hospitals in China: Evidence from Guangdong

Cited by 6 publications

References 18 publications

Comparing public and private hospitals in China: Evidence from Guangdong

Comparing public and private hospitals in China: Evidence from Guangdong

Medical Malpractice Litigation Following Spine Surgery in Beijing: The Past 6 Years.

Submerged discontent and patterns of accommodation: a case study of doctors' pay in two public hospitals in China

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Comparing Public and Private Hospitals in China: Evidence from Guangdong

Cited by 6 publications

References 18 publications

Comparing public and private hospitals in China: Evidence from Guangdong

Comparing public and private hospitals in China: Evidence from Guangdong

Medical Malpractice Litigation Following Spine Surgery in Beijing: The Past 6 Years.

Submerged discontent and patterns of accommodation: a case study of doctors' pay in two public hospitals in China

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Product

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Medical Malpractice Litigation Following Spine Surgery in Beijing: The Past 6 Years.