公立医院改革能否减少医疗资源错配?来自中国的证据。

IF 2.7 3区 经济学 Q1 ECONOMICS
Yulin Chai, Ying Liu, Shanna Li, Linlin Zhang, Dan Chen, Wenqiang Yin, Lin Guo
{"title":"公立医院改革能否减少医疗资源错配?来自中国的证据。","authors":"Yulin Chai, Ying Liu, Shanna Li, Linlin Zhang, Dan Chen, Wenqiang Yin, Lin Guo","doi":"10.1186/s13561-024-00567-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The mismatch of medical resources is a significant issue in global healthcare, undermining both service accessibility and system efficiency. In China, despite the implementation of the \"Healthy China\" strategy, persistent mismatches remain due to factors such as industrialization, urbanization, and population aging. This study empirically evaluates the impact of Public Hospital Reform (PHR) on mitigating these mismatches.</p><p><strong>Methods: </strong>A Difference-in-Differences (DD) approach is applied to panel data from 300 cities spanning 2010 to 2021, using the phased implementation of PHR as a quasi-natural experiment. This allows for a comparative analysis of changes in resource allocation between cities that adopted the reform and those that did not. Quantile regression assesses the effects of PHR across varying levels of resource mismatch, while mechanism tests investigate how PHR influences mismatches through cost reduction and supply expansion.</p><p><strong>Results: </strong>PHR is found to reduce medical resource mismatches by 13.9%, primarily driven by cost reductions and increased resource supply. The effects are more pronounced at both lower and higher levels of mismatch, with a limited impact at mid-levels. Furthermore, the reform's effectiveness diminishes as it is extended to more cities, suggesting a potential saturation effect.</p><p><strong>Conclusions: </strong>This study demonstrates that PHR significantly alleviates medical resource mismatches in China. The findings underscore the need to focus on cost control and resource supply in future healthcare reforms, providing key insights for policymakers in developing countries facing similar healthcare resource challenges.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"88"},"PeriodicalIF":2.7000,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520715/pdf/","citationCount":"0","resultStr":"{\"title\":\"Can public hospital reform reduce medical resource mismatches? Evidence from China.\",\"authors\":\"Yulin Chai, Ying Liu, Shanna Li, Linlin Zhang, Dan Chen, Wenqiang Yin, Lin Guo\",\"doi\":\"10.1186/s13561-024-00567-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The mismatch of medical resources is a significant issue in global healthcare, undermining both service accessibility and system efficiency. In China, despite the implementation of the \\\"Healthy China\\\" strategy, persistent mismatches remain due to factors such as industrialization, urbanization, and population aging. This study empirically evaluates the impact of Public Hospital Reform (PHR) on mitigating these mismatches.</p><p><strong>Methods: </strong>A Difference-in-Differences (DD) approach is applied to panel data from 300 cities spanning 2010 to 2021, using the phased implementation of PHR as a quasi-natural experiment. This allows for a comparative analysis of changes in resource allocation between cities that adopted the reform and those that did not. Quantile regression assesses the effects of PHR across varying levels of resource mismatch, while mechanism tests investigate how PHR influences mismatches through cost reduction and supply expansion.</p><p><strong>Results: </strong>PHR is found to reduce medical resource mismatches by 13.9%, primarily driven by cost reductions and increased resource supply. The effects are more pronounced at both lower and higher levels of mismatch, with a limited impact at mid-levels. Furthermore, the reform's effectiveness diminishes as it is extended to more cities, suggesting a potential saturation effect.</p><p><strong>Conclusions: </strong>This study demonstrates that PHR significantly alleviates medical resource mismatches in China. The findings underscore the need to focus on cost control and resource supply in future healthcare reforms, providing key insights for policymakers in developing countries facing similar healthcare resource challenges.</p>\",\"PeriodicalId\":46936,\"journal\":{\"name\":\"Health Economics Review\",\"volume\":\"14 1\",\"pages\":\"88\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-10-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520715/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Health Economics Review\",\"FirstCategoryId\":\"96\",\"ListUrlMain\":\"https://doi.org/10.1186/s13561-024-00567-7\",\"RegionNum\":3,\"RegionCategory\":\"经济学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ECONOMICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Economics Review","FirstCategoryId":"96","ListUrlMain":"https://doi.org/10.1186/s13561-024-00567-7","RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ECONOMICS","Score":null,"Total":0}
引用次数: 0

摘要

背景:医疗资源不匹配是全球医疗保健领域的一个重要问题,它既影响服务的可及性,也影响系统效率。在中国,尽管实施了 "健康中国 "战略,但由于工业化、城市化和人口老龄化等因素,医疗资源不匹配的问题依然存在。本研究通过实证研究评估了公立医院改革对缓解这些错配现象的影响:方法:采用差分法(DD)对 300 个城市 2010 年至 2021 年的面板数据进行分析,将分阶段实施 PHR 作为准自然实验。这样就可以比较分析采用改革和未采用改革的城市之间资源分配的变化。量子回归评估了 PHR 在不同资源错配水平下的效果,而机制检验则研究了 PHR 如何通过降低成本和扩大供应来影响资源错配:结果:PHR 能将医疗资源错配率降低 13.9%,主要原因是成本降低和资源供应增加。在错配程度较低和较高的情况下,效果更为明显,而在中等程度的情况下,影响有限。此外,随着改革扩展到更多的城市,其效果也会减弱,这表明改革可能会产生饱和效应:本研究表明,在中国,个人健康记录能显著缓解医疗资源错配问题。研究结果强调了在未来医疗改革中关注成本控制和资源供应的必要性,为面临类似医疗资源挑战的发展中国家的政策制定者提供了重要启示。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Can public hospital reform reduce medical resource mismatches? Evidence from China.

Background: The mismatch of medical resources is a significant issue in global healthcare, undermining both service accessibility and system efficiency. In China, despite the implementation of the "Healthy China" strategy, persistent mismatches remain due to factors such as industrialization, urbanization, and population aging. This study empirically evaluates the impact of Public Hospital Reform (PHR) on mitigating these mismatches.

Methods: A Difference-in-Differences (DD) approach is applied to panel data from 300 cities spanning 2010 to 2021, using the phased implementation of PHR as a quasi-natural experiment. This allows for a comparative analysis of changes in resource allocation between cities that adopted the reform and those that did not. Quantile regression assesses the effects of PHR across varying levels of resource mismatch, while mechanism tests investigate how PHR influences mismatches through cost reduction and supply expansion.

Results: PHR is found to reduce medical resource mismatches by 13.9%, primarily driven by cost reductions and increased resource supply. The effects are more pronounced at both lower and higher levels of mismatch, with a limited impact at mid-levels. Furthermore, the reform's effectiveness diminishes as it is extended to more cities, suggesting a potential saturation effect.

Conclusions: This study demonstrates that PHR significantly alleviates medical resource mismatches in China. The findings underscore the need to focus on cost control and resource supply in future healthcare reforms, providing key insights for policymakers in developing countries facing similar healthcare resource challenges.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
3.90
自引率
4.20%
发文量
59
审稿时长
13 weeks
期刊介绍: Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信