Publication: The Role of For-Profit Hospitals in Medical Expenditures : Evidence from Aggregate Data in China
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Published
2009
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1043-951X
Date
2012-03-30
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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 oil 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. (C) 2009 Elsevier Inc. All rights reserved.
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Publication 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.Publication The Impact of SEWA's Medical Insurance Fund on Hospital Utilization and Expenditure : A Household Survey(World Bank, Washington, DC, 2001-09)This paper assesses the impact of the Self-Employed Women's Association's (SEWA's) Medical Insurance Fund, Gujarat, in terms of inclusion of the poor, hospital utilization, and expenditure. Age-matched insured and uninsured women were compared using survey data (2000). 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Evidence from Nigeria(World Bank Group, Washington, DC, 2015-02)Inorganic fertilizer use across Sub-Saharan Africa is generally considered to be low. Yet, this belief is predicated on the assumption that it is profitable to use rates higher than currently observed. However, there is little rigorous empirical evidence to support this notion. Using a nationally representative panel data set, and with due recognition of the role of risk and uncertainty, this paper empirically estimates the profitability of fertilizer use for maize production in Nigeria. The analysis finds that inorganic fertilizer use in Nigeria is not as low as conventional wisdom suggests. Low marginal physical product and high transportation costs significantly reduce the profitability of fertilizer use. The paper finds evidence that strategies to reduce transportation costs are likely to have a much larger effect on the profitability of fertilizer use than fertilizer subsidies. 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