دورية أكاديمية

Heterogeneous effects of hospital competition on inpatient expenses: an empirical analysis of diseases grouping basing on conditions’ complexity and urgency

التفاصيل البيبلوغرافية
العنوان: Heterogeneous effects of hospital competition on inpatient expenses: an empirical analysis of diseases grouping basing on conditions’ complexity and urgency
المؤلفون: Liyong Lu, Xiaojun Lin, Jay Pan
المصدر: BMC Health Services Research, Vol 21, Iss 1, Pp 1-16 (2021)
بيانات النشر: BMC, 2021.
سنة النشر: 2021
المجموعة: LCC:Public aspects of medicine
مصطلحات موضوعية: Hospital competition, K-means clustering, Predicted patient flow approach, Inpatient expense, China, Public aspects of medicine, RA1-1270
الوصف: Abstract Background Multiple pro-competition policies were implemented during the new round of healthcare reform in China. Differences in conditions’ complexity and urgency across diseases associating with various degrees of information asymmetry and choice autonomy in the process of care provision, would lead to heterogeneous effects of competition on healthcare expenses. However, there are limited studies to explore it. This study aims to examine the heterogeneous effects of hospital competition on inpatient expenses basing on disease grouping according to conditions’ complexity and urgency. Methods Collecting information from discharge data of inpatients and hospital administrative data of Sichuan province in China, we selected representative diseases. K-means clustering was used to group the selected diseases and Herfindahl-Hirschman Index (HHI) was calculated based on the predicted patient flow to measure the hospital competition. The log-linear multivariate regression model was used to examine the heterogeneous effects of hospital competition on inpatient expenses. Results We selected 19 representative diseases with significant burdens (more than 1.1 million hospitalizations). The selected diseases were divided into three groups, including diseases with highly complex conditions, diseases with urgent conditions, and diseases with less complex and less urgent conditions. For diseases with highly complex conditions and diseases with urgent conditions, the estimated coefficients of HHI are mixed in the direction and statistical significance in the identical regression model at the 5% level. For diseases with less complex and less urgent conditions, the coefficients of HHI are all positive, and almost all of them significant at the 5% level. Conclusions We found heterogeneous effects of hospital competition on inpatient expenses across disease groups: hospital competition does not play an ideal role in reducing inpatient expenses for diseases with highly complex conditions and diseases with urgent conditions, but it has a significant effect in reducing inpatient expenses of diseases with less complex and less urgent conditions. Our study offers implications that the differences in condition’s complexity and urgency among diseases would lead to different impacts of hospital competition, which would be given full consideration when designing the pro-competition policy in the healthcare delivery system to achieve the desired goal.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 1472-6963
Relation: https://doaj.org/toc/1472-6963
DOI: 10.1186/s12913-021-07331-1
URL الوصول: https://doaj.org/article/d40a682c597c4e63b9e5c42ce662c08f
رقم الأكسشن: edsdoj.40a682c597c4e63b9e5c42ce662c08f
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:14726963
DOI:10.1186/s12913-021-07331-1