Person:
Hou, Xiaohui
Author Name Variants
Fields of Specialization
health economics; social safety nets; poverty
Degrees
ORCID
Departments
Health, Nutrition and Population, East Asia and Pacific Region, World Bank
Externally Hosted Work
Contact Information
Last updated
January 31, 2023
Biography
Hou, Xiaohui is a Senior Economist in the World Bank. Joined as a Young Professional, she has since worked in Human Development department and Poverty Reduction and Economic Management department across the East Europe and Central Asia region, the South Asia region, and most recently the East Asia and Pacific region. She also spent a number of years in the World Bank Institute, the capacity building arm of the World Bank, focusing on face to face training and network development. Her fields include health economics, social safety net, labor economics and impact evaluation. She has published a dozen of papers in both economics and medical peer reviewed journals. She also teaches as a visiting scholar. A Peking University graduate, she obtained her Ph.D. in the Health Services and Policy Analysis and a Master’s degree in Economics from the University of California, Berkeley, and a Master’s degree in Health Policy and Administration from the Washington State University.
Publication Search Results
1 - 10 of 24
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Symposium on Health Economics Issues in China: The Role of For-Profit Hospitals in Medical Expenditures: Evidence from Aggregate Data in China
( 2009)The health care delivery system in China, which is dominated by state hospitals, is being increasingly challenged by public concerns: it is too expensive and too inaccessible, a complaint commonly phrased as "kai bin nan, kan bin gui" in Chinese. As the penetration of for-profit hospitals has gradually increased, there is a growing need for policy research to assess their impact on medical spending from the patient perspective. Using panel data at the provincial level in China, this paper examines the impact of the penetration of for-profit hospitals on average medical expenditures for both outpatient and inpatient services in public general hospitals. Based on fixed-effect model estimates, the study shows that the penetration of for-profit hospitals has lowered the average medical expenditures for both inpatient and outpatient services across regions, especially for pharmaceuticals. Together with other results, this study finds no evidence that private for-profit hospitals drive up average medical expenditures while serving their profit-maximization objectives. Rather, they help increase the market supply of health care, which in turn better serves the increasing demand. -
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The value of lost output and cost of illness of noncommunicable diseases in the Pacific
(Elsevier, 2022-12-01)The Pacific Island Countries face some of the highest rates of Noncommunicable Diseases (NCDs). This study estimates the economic costs of NCDs for each year from 2015 to 2040, focusing on eleven Pacific Island nations. Data and Methods: two methods were used to estimate the mortality and morbidity costs using a ‘value of lost output’ and ‘cost of illness’ approach respectively. Results: Five results stand out in terms of projected economic costs of NCD mortality and morbidity analyses in the Pacific: (i) the economic burden of NCDs in the Pacific is greater than expected for middle‐income countries; (ii) although cardiovascular disease is the biggest contributor to the mortality burden in the region, diabetes plays a far greater role in the Pacific countries compared to the global average; (iii) the economic burden of NCDs is increasing with time, especially as incomes rise; (iv) the biggest driver of lost output is the potential loss of labor due to early death from NCDs; and (v) the cost of illness due to diabetes is high across the Pacific countries, with highest among the Polynesian countries. NCDs alone can put enormous threat to the small Pacific economies. Targeted interventions to reduce disease prevalence, as outlined in the Pacific NCDs Roadmap, are vital to reduce the long-term costs associated with NCD mortality and morbidity. -
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Exploring Factors Driving the Performance of Rural Health Care in Papua New Guinea
(World Bank, Washington, DC, 2018-06-06)Examining performance patterns of sub-national units, such as provinces and districts, within a health system is important to understand their drivers and what might be needed to improve outputs. Such literature is relatively rare in low and middle-income countries. It is particularly relevant for Papua New Guinea, which is underperforming in relation to its neighbours and targets for core health indicators and faces particular geographical challenges, with a dispersed and diverse population. In this analysis, we undertake simple correlation analysis between remoteness of populations, expenditure on frontline services and core outputs by provinces and regions, such as antenatal care, outpatient visits, outreach clinics, referrals of patients and facility supervision in 2012. In the context of the challenging geography of Papua New Guinea, these are expected to be important factors. Some expected patterns were found – for example, between remoteness and higher service costs, as well as between remoteness and higher outreach services. Outpatient visits, however, increased with remoteness, which was surprising. Our correlation analyses suggest a virtuous circle operating in some areas (even in the most geographically challenged) between outreach clinics, immunisation coverage, supervision, frontline spending and overall health system performance, which merits further investigation into the factors supporting these and how they can be reinforced elsewhere. Whilst expenditure did not correlate closely with provincial performance, it was evident that the provinces with higher performance across the selection of metrics typically were also the higher spenders on frontline services. There was some correlation of higher performance with density of public provision. More fine-grained assessment, including at the district level, will be needed to understand the low levels of outreach clinics, transfers and supervision, all of which are critical for quality health care in these kinds of contexts. The analysis illustrates what can be learned from combining routine data sources, as well as the limits and the need to complement such analysis with more detailed local qualitative investigations. It also reinforces the message that local leadership, supportive supervision and resources directed to frontline services can be effective in raising health system performance, even in challenging settings. -
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An Evaluation of the Initial Impact of the Medical Assistance Program for the Poor in Georgia
(World Bank, Washington, DC, 2008-04)As part of the recent health reform effort, the government of Georgia launched a Medical Assistance Program in June 2006 to provide health insurance to its poor population. So far the program covers slightly over 50 percent of the poor and provides benefit coverage for outpatient and inpatient care. This paper estimates initial impact of the Medical Assistance Program and assesses whether the benefits have reached the poorest among those eligible, using utilization data from June 2006 to December 2006. Based on the analysis using a regression discontinuity design and a three-part model, the paper presents two main findings. First, the Medical Assistance Program has significantly increased utilization of acute surgeries/inpatient services by the poor. Second, the benefits have successfully reached the poorest among the poor. These two findings indicate that government efforts to improve the poor's access to and utilization of health services are yielding results. The paper emphasizes that the initial dramatic increase in surgeries must be interpreted with caution, given the possible misclassification or misreporting of acute surgeries in the data. The paper also stresses the need to continue monitoring implementation of the Medical Assistance Program and further improve program design, particularly the targeting mechanism, to achieve better efficiency, effectiveness and overall equity in access to health care services. -
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Challenges for Youth Employment in Pakistan : Are They Youth-Specific?
( 2011-01-01)This paper analyzes the patterns of and the challenges for youth employment in Pakistan and examines whether these challenges are youth-specific. Using the 2005/2006 Labor Force Survey, the analysis includes determinants of unemployment, determinants of working in the formal sector, rate of return on education, and determinants of working hours. The paper finds that many of the challenges to youth employment in Pakistan are not youth-specific. Policies should thus emphasize broader labor market reforms, even in the context of tackling youth employment issues. Still, some challenges are youth-specific, such as a higher youth unemployment rate and insufficient returns to better-educated youth. To address these challenges, more youth-specific interventions are needed. -
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Empowering Women : The Effect of Women’s Decision-Making Power on Reproductive Health Services Uptake - Evidence from Pakistan
( 2011-01-01)A large body of research has attempted to explore the links between women's autonomy and their uptake of reproductive health services in the South Asia region, but the evidence so far is inconclusive. This study uses the Pakistan Social and Living Standards Measurement Survey to examine the influence of household decision making on women's uptake of reproductive health services. The analysis finds that women's decision-making power has a significant positive correlation with reproductive health services uptake and that influential males' decision-making power has the opposite effect, after controlling for socio-economic indicators and supply-side conditions. The findings suggest that empowering women and increasing their ability to make decisions may increase their uptake of reproductive health services. They also suggest that policies directed toward improving women's utilization of maternity services must target men as well as women in Pakistan. -
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The Emergence of Proprietary Medical Facilities in China
( 2008)This paper analyzes the evolution and development of market conditions and government policies that have favored the emergence of proprietary medical facilities in China. Excess and differentiated demand for medical services, the existent profitability and supply of the investment capital in health care market, and favorable government policies have encouraged the entrance of proprietary facilities in health care market. The paper further analyzes why nonprofit health organizations are not an optimal organizational form in the current Chinese health care market. After discussing the strengths and weaknesses of proprietary ownership in health care market in China, the paper concludes with important managerial and policy suggestions. -
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Targeted or Untargeted? The Initial Assessment of a Targeted Health Insurance Program for the Poor in Georgia
( 2011)The government of Georgia launched a Medical Insurance Program, a targeted health insurance program, in June 2006 to provide health insurance to the poor. Using administrative data from June 2006 to December 2006, this paper estimates the initial impact of the Medical Insurance Program relative to an untargeted health insurance program and assesses whether the benefits have reached the poorest among those eligible. The paper presents two main findings: first, the Medical Insurance Program has significantly increased beneficiaries' utilization of public health insurance for acute surgeries and inpatient services; and second, the benefits have reached the poorest among the beneficiaries. However, the findings are only applicable to the first six months of implementation and more analysis is required to understand the dynamics and long term impact of the reform. -
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Reforming the Basic Benefits Package in Armenia: Modeling Insights from the Health Interventions Prioritization Tool
(World Bank, Washington, DC, 2021-03-26)Armenia is an upper-middle-income (UMI) country in the South Caucasus region. The Coronavirus (COVID-19) pandemic and a regional crisis have resulted in the real economy's contraction following rapid growth in the past five years. Improving access to high-quality health care is essential for responding to non-communicable diseases (NCDs) and preventing mortality from infectious diseases in Armenia. Armenia is faced with the challenge of achieving Universal Health Coverage (UHC) when funding for health services faces downward pressures due to a donor funding transition, the Coronavirus (COVID-19) pandemic, and regional conflict. This report is part of the World Bank’s technical support toward universal health coverage in Armenia, which includes advisory services and analytics aimed at supporting the government’s efforts to expand access to high-quality health care. The report draws on the Health Interventions prioritization tool to optimize allocations across essential health services in the basic benefits package and estimate the potential impact of these allocations on population health. -
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The Heterogeneous Effects of a Food Price Crisis on Child School Enrollment and Labor : Evidence from Pakistan
(World Bank, Washington, DC, 2013-08)Using a panel survey, this paper investigates how the increase in food prices in Pakistan in 2008-2010 affected children's school enrollment and labor. The causal identification relies on geographical variations in the price of food (wheat). The results show that the negative impacts of food price increase on school enrollment differ by gender, economic status, and the presence of siblings. The negative effects on school do not directly correspond to the increase in child labor because the transition from being idle to labor activity or from school to being idle are significant, particularly among the poor girls. The results also show that children in households with access to agricultural land are not affected by higher food prices. The analyses reveal a more dynamic picture of the impact of food price increase on child status and contribute to broader policy discussion to mitigate the impact of crises on children's education.