The role of for-profit hospitals in medical expenditures: Evidence from aggregate data in China

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.     

浙江省居民医疗服务满意度研究——基于对大医院、私人门诊和社区医院的调查

医疗服务的总体满意度与个体的真实感受差距较大,本文分别就大医院、私人门诊和社区医院的医疗服务对浙江省城乡居民开展满意度问卷调查,结果显示,不同类别的医院居民满意和不满意的方面差别较大,且近一半的居民都选择去大医院接受医疗服务,大医院的医疗服务满意度对总体满意度的影响最大,社区医院满意度对总体满意度影响不显著。     

How does people’s liberation army related business closure affect the local economy?

People’s Liberation Army (PLA) related business was rampant in China in the 1980s and 1990s, and they significantly disrupted the local economy. However, due to limited data about PLAs, this issue is rarely investigated and thus the negative impact is hardly measured. In this paper we introduce a new proxy for measuring the approximate level of PLA related business in a specific city, PLA hospital score, to identify cities that are more affected by PLA related business closure. We then employ a difference-in-differences (DID) framework and show that PLA related business closure does bring positive effects to China’s local economy, about a 2% increase in GDP growth per year. We also find that this effect is more significant in cities with median economic size and cities that rely more on secondary and tertiary sectors. We finally provide a possible channel of this effect, which mainly works through providing a more efficient and competitive market to local private firms as well as an investment-friendly environment that attracts foreign investments.