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Health Insurance Reform and Efficiency of Township Hospitals in Rural China: An Analysis from Survey Data

By Xiao Xian HUANG, Aurore PELISSIER, Jacky MATHONNAT, Martine AUDIBERT and Anning MA

Abstract

In the rural health-care organization of China, township hospitals ensure the delivery of basic medical services. Particularly damaged by the economic reforms implemented from 1975 to the end of the 1990s, township hospitals efficiency is questioned, mainly with the implementation since 2003 of the reform of health insurance in rural areas. From a database of 24 randomly selected township hospitals observed over the period 2000-2008 in Weifang prefecture (Shandong), the study examines the efficiency of township hospitals through a two-stage approach. As curative and preventive medical services delivered at township hospital level use different production processes, two data envelopment analysis models are estimated with different orientation chosen to compute scores. Results show that technical efficiency declines over time. Factors explaining the technical efficiency are mainly environmental characteristics rather than internal factors, but our results suggest also that in the context of China, the efficiency of township hospitals is influenced by unobservable factors.China, New Rural Cooperative Medical Scheme, Technical efficiency, data envelopment analysis, Township Hospitals.

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  1. (2008). A cross-national comparison and taxonomy of DEA-based hospital efficiency studies, Socio-Economic Planning Sciences.
  2. (1980). A survey of frontier production functions and of their relationship to efficiency measurement,
  3. (2008). Activité et performance des hôpitaux municipaux en Chine rurale – Une analyse sur données d’enquêtes dans la province de Shandong, Revue d’Économie du Développement.
  4. (1991). Applied data envelopment analysis.
  5. (2007). Behavioral differences between public and private not-for-profit hospitals in the Italian national health service,
  6. (2008). Cost and technical efficiency of German hospitals: does ownership matter?
  7. (2008). Couttolenc BF, Hospital Performance in Brazil, World Bank,
  8. (1994). Data Envelopment Analysis: Theory, Methodology and Application,
  9. (1998). Determinants of Hospital Efficiency: the Case of Central Government-owned Hospitals on Taiwan,
  10. (2008). Efficiency of Thai provincial public hospitals during the introduction of universal health coverage using capitation, Health Care Management Sciences.
  11. (2010). Exploring the use of social network methods in designing healthcare quality improvement teams, Social Sciences and Medicine.
  12. (1997). Financing Health Care: issues and options for China, World Bank,
  13. (1996). Health care systems in transition: People's Republic of China. Part I: An overview of China's health care system,
  14. (2008). Health Service delivery in China: a literature review,
  15. (2004). Hospital Ownership and Operating Efficiency: Evidence from Taiwan,
  16. (2000). Hospital Ownership and Public Medical Spending,
  17. (2002). Identifying sub-areas that comprise a greater metropolitan area: the criterion of county relative efficiency,
  18. (2003). Innovations in health services delivery – The corporatization of public hospitals, Human Development Network, Health, Nutrition and Population series, World Bank,
  19. (1997). L'efficacité technique des chemins de fer en Afrique Subsaharienne: une comparaison internationale par la méthode DEA, Revue d’Economie du Développement.
  20. (1986). La performance productive d’un service public. Définitions, méthodes de mesure et application à la Régie des Postes en Belgique, L'Actualité économique. 62
  21. (1995). Les inégalités entre hôpitaux, Obstacle à l'efficacité et à l'équité de la maîtrise des dépenses hospitalières,
  22. (2006). Measuring Efficiency In Health Care,
  23. (1978). Measuring the efficiency of decision making units,
  24. (2003). Non-Parametric and Parametric Applications Measuring Efficiency in Health Care,
  25. (2003). People’s Republic of China. Toward Establishing A Rural Health Protection System, Asian Development Bank,
  26. (2010). Realignment of incentives for healthcare providers in China,
  27. (1990). Recent Developments in DEA. The mathematical programming approach to frontier analysis,
  28. (1996). Reforming China’s 50,000 Township Hospitals: Effectiveness, Challenges, and Opportunities, Health Policy.
  29. (2009). Reforming China’s Rural Health System, World Bank,
  30. (2009). Soft budget constraints in China: Evidence from the Guangdong hospital industry,
  31. (1984). Some models for estimation technical and scale inefficiencies in Data Envelopment Analysis,
  32. (1995). The Chinese Health Care system: lessons for other nations,
  33. (2008). The Chinese health system at a crossroads, Health Affairs.
  34. (2009). The effect of soft budget constraints on access and quality in hospital care,
  35. (1957). The measurement of productive efficiency,
  36. (2009). The soft budget constraint syndrome in the hospital sector,
  37. (1984). Transformation of health care in China. The New England

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