2022
DOI: 10.1136/bmjopen-2021-051538
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Creating accountable hospital service areas in China: a case analysis of health expenditure in the metropolis of Chengdu

Abstract: ObjectivesTo delineate hospital service areas (HSAs) using the Dartmouth approach in China and identify the hypothesised demand-side, supply-side and region-specific factors of health expenditure within HSAs.DesignPopulation-based descriptive study.SettingWe selected the metropolis of Chengdu, one of the three most populous cities in China as a case for the analysis, where approximately 16.33 million residents living.ParticipantsIndividual-level in-patient discharge records (n=904 298) during the fourth quarte… Show more

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Cited by 4 publications
(4 citation statements)
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“…According to the previous literature, 18 hospital discharge records with incomplete addresses can be randomly assigned to townships/subdistricts based on the available information to delineate HSAs. This portion of the records provides information about the county/district where the patients are located.…”
Section: Resultsmentioning
confidence: 99%
See 1 more Smart Citation
“…According to the previous literature, 18 hospital discharge records with incomplete addresses can be randomly assigned to townships/subdistricts based on the available information to delineate HSAs. This portion of the records provides information about the county/district where the patients are located.…”
Section: Resultsmentioning
confidence: 99%
“…6 - 11 Recently, similar studies to investigate dramatic variations in healthcare across regions have also been conducted under the contexts of other nations, including Canada, 12 Germany, 13 Sweden, 14 Italy, 15 Spain, 16 Switzerland, 17 and China. 18 When it comes to analyzing potential determinants of variations in healthcare expenditures, such variations are typically divided by researchers into “unwarranted” and “warranted” components based on the widely accepted criteria that variations should be recognized as “warranted” only if such variations can be explained by particular demand-side factors that reflect differences in patient needs or preferences. 19 Otherwise, the variations would be considered as unwarranted if they are found to be mainly driven by supply factors, such as supplier-induced demand, 20 defensive medicine, 21 and medical arms race.…”
Section: Introductionmentioning
confidence: 99%
“…In the same year, the population of this city exceeded 16 million, making Chengdu one of the most populous cities in China with a fast-growing urbanization rate of 74.41% 21 . As a metropolitan city located in southwest China, Chengdu has abundant medical resources supported by a well-established social health insurance system 22 . Chengdu is also one of the cities in China where a wide range of rare disease types have been identi ed with plenty of rare disease cases for epidemiological analysis 23 .…”
Section: Study Areamentioning
confidence: 99%
“…In China, despite substantial investments in healthcare resources by the Chinese government, the national-level feat of improvement belied the persistent disparities at the sub-national level [ 52 54 ]. However, extant studies have primarily focused on disparities at the provincial level [ 41 , 55 , 56 ], overlooking small-area spatiotemporal inequalities [ 57 ]. Given that counties serve as the cornerstone of healthcare system reform in China and represent the smallest administrative unit for healthcare resource allocation [ 58 , 59 ], our representative case centers on county-level hospital beds in China.…”
Section: Introductionmentioning
confidence: 99%