Hospital competition under regulated prices: application to urban health sector reforms in China.
We develop a model of public-private hospital competition under regulated prices, recognizing that hospitals are multi-service firms and that equilibria depend on the interactions of patients, hospital administrators, and physicians. We then use data from China to calibrate a simulation model of the impact of China's recent payment and organizational reforms on cost, quality and access. Both the analytic and simulation results show how providing implicit insurance through distorted prices leads to over/under use of services by profitability, which in turn fuels cost escalation and reduces access for those who cannot afford to self-pay for care. Simulations reveal the benefits of mixed payment and expanded insurance cover for mitigating these distortions.
Department of Economics, Tufts University, Braker Hall, Medford, MA 02155, USA. karen.eggleston@tufts.edu
Karen
K
Eggleston
Winnie
W
Yip
D002681:China; D003198:Computer Simulation; D004465:Economic Competition / Q000331:legislation & jurisprudence*; D018166:Health Care Reform / Q000191:economics / Q000331:legislation & jurisprudence*; D006297:Health Services Accessibility; D017722:Hospital Charges / Q000331:legislation & jurisprudence*; D016304:Hospitals, Private / Q000191:economics* / Q000458:organization & administration / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000191:economics* / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D007350:Insurance, Hospitalization; D017059:Models, Econometric; D010342:Patient Acceptance of Health Care