Public and Private Hospitals, Congestion, and Redistribution

Canta, Chiara; Leroux, Marie‐Louise

doi:10.1111/jpet.12132

Cited by 2 publications

(3 citation statements)

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“…However, if the social planner weighs heavily the welfare of patients with low delay costs, and patients are sufficiently heterogeneous, it is optimal to maintain positive waiting times in the public system so that patients highly averse to delays opt out of the public system and the per-capita cost of public service is reduced for everyone. Canta and Leroux (2012) extend Hoel and Saether (2003) by assuming that patients differ in income. They show that a social planner with a utilitarian welfare function and preferences for income redistribution can implement a (first-best) welfare optimum through lump-sum taxation and a subsidy on the private hospital fee.…”

Section: Literature Reviewmentioning

confidence: 99%

“…In contrast to Hoel and Saether (2003) and Canta and Leroux (2012), our goal is to analyze and compare the effectiveness of subsidy schemes in reducing service delays and waiting time cost. Hoel and Saether (2003) assume that public waiting time is independent of demand, and that there is no budget constraint on subsidization of private care.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Hoel and Saether (2003) assume that public waiting time is independent of demand, and that there is no budget constraint on subsidization of private care. Moreover, both Hoel and Saether (2003) and Canta and Leroux (2012) adopt a deterministic approach in modeling patient waiting time. This is suitable for settings in which the subsidy is unconditional, and patients join or balk from the public healthcare system based on expected waiting time.…”

Section: Literature Reviewmentioning

confidence: 99%

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Comparison of Subsidy Schemes for Reducing Waiting Times in Healthcare Systems

Qian

Guo

Lindsey

2017

Production and Operations Management

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T his study analyzes subsidy schemes that are widely used in reducing waiting times for public healthcare service. We assume that public healthcare service has no user fee but an observable delay, while private healthcare service has a fee but no delay. Patients in the public system are given a subsidy s to use private service if their waiting times exceed a pre-determined threshold t. We call these subsidy schemes (s, t) policies. As two extreme cases, the (s, t) policy is called an unconditional subsidy scheme if t = 0, and a full subsidy scheme if s is equal to the private service fee. There is a fixed budget constraint so that a scheme with larger s has a larger t. We assess policies using two criteria: total patient cost and serviceability (i.e., the probability of meeting a waiting time target for public service). We prove analytically that, if patients are equally sensitive to delay, a scheme with a smaller subsidy outperforms one with a larger subsidy on both criteria. Thus, the unconditional scheme dominates all other policies. Using empirically derived parameter values from the Hong Kong Cataract Surgery Program, we then compare policies numerically when patients differ in delay sensitivity. Total patient cost is now unimodal in subsidy amount: the unconditional scheme still yields the lowest total patient cost, but the full subsidy scheme can outperform some intermediate policies. Serviceability is unimodal too, and the full subsidy scheme can outperform the unconditional scheme in serviceability when the waiting time target is long.

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Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

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Comparison of Subsidy Schemes for Reducing Waiting Times in Healthcare Systems

Qian

Guo

Lindsey

2017

Production and Operations Management

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Impact of provincial economic development levels on public–private hospital co-development in China: an empirical analysis

Xu,

Tan,

Nicholas

et al. 2024

BMJ Open

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IntroductionThe co-development of public–private hospitals in China’s healthcare system significantly influences the system’s service utilisation, but the public–private hospital interaction is poorly understood. Bridging this knowledge gap is crucial for informed policy-making and promoting a more balanced healthcare system. This study measures China’s public–private hospital co-development and the impact of provincial and regional economic development levels on public–private hospital co-development.MethodsWe use service utilisation, a comprehensive measure of resource allocation, service capacity and service efficiency, to assess the co-development of China’s public and private hospitals. Using the coupling coordination degree model, a novel approach borrowed from physics, we measured the degree of interaction between the public and private pillars of China’s hospital system. Second, we measured the relationship between the degree of private–public hospital interaction and the level of provincial–regional economic development, including provincial direct and spillover effects. Data were collected on 2011–2021 service utilisation across 31 Chinese provinces. Fixed-effect models and the spatial Durbin model estimated the direct and spillover effects between the coupling coordination degree and the level of provincial economic development.ResultsWe found that national, regional and provincial service utilisation in private hospitals expanded, while service utilisation remained constant in public hospitals. China’s private–public hospital co-development improved from the ‘barely co-developed’ (0.696 in 2011) to the ‘partially co-developed’ level (0.752 in 2021) in the public–private transitional co-development stage. We identified significant regional heterogeneity, with the eastern region co-development slightly better than the central region and both substantially better than the western region. There was also significant provincial heterogeneity. Increases in regional and provincial economic development promoted the service utilisation of private hospitals, improving the balanced co-development of public–private hospitals in the home and adjacent provinces (p<0.05).ConclusionsTo improve the co-development of public–private hospitals and avoid regional imbalances, regional and provincial hospital policies and regulations should be coordinated and equitable; private hospitals should cooperate with public hospitals through their professional management teams and medical equipment sharing to equalise medical resource allocations; and regional economic disparities should be addressed.

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Public and Private Hospitals, Congestion, and Redistribution

Cited by 2 publications

References 23 publications

Comparison of Subsidy Schemes for Reducing Waiting Times in Healthcare Systems

Comparison of Subsidy Schemes for Reducing Waiting Times in Healthcare Systems

Impact of provincial economic development levels on public–private hospital co-development in China: an empirical analysis

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