An evaluation of systemic reforms of public hospitals: the Sanming model in China

Health Policy and Planning
Hongqiao FuWilliam Hsiao

Abstract

Low- and middle-income countries (LMICs) have been searching for effective strategies to reform their inefficient and wasteful public hospitals. Recently, China developed a model of systemic reforms called the Sanming model to address the inefficiency and waste at public hospitals. In this article, we explain and evaluate how the Sanming model reformed its 22 public hospitals in 2013 by simultaneously restructuring the hospital governance structure, altering the payment system to hospitals, and realigning physicians' incentives. By employing the difference-in-difference (DID) method and using the hospital-level data from 187 public hospitals in Fujian province, we find that the Sanming model has reduced medical costs significantly without measurably sacrificing clinical quality and productive efficiency. The systemic reform, on average, has reduced the medical care cost per outpatient visit and per inpatient admission by 6.1% (P-value = 0.0445) and 15.4% (P-value < 0.001), respectively. It is largely accomplished through a decrease in drug expenditures per outpatient visit and per inpatient admission of about 29% (P-value < 0.001) and 53% (P-value < 0.001). These results show that the Sanming model has achieved at least a short...Continue Reading

References

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Citations

Jul 30, 2019·Journal of the American Geriatrics Society·Wen-Jun TuQiang Liu
Sep 10, 2019·PloS One·Sheng Nong, Nengliang Aaron Yao
Apr 1, 2020·International Journal of Environmental Research and Public Health·Richard Huan XuDong Wang
Jan 11, 2020·International Journal of Clinical Pharmacy·Zhuo MaLiHong Liu
Apr 8, 2020·BMJ Global Health·Wenjuan TaoGerald F Kominski
Jan 16, 2019·International Journal of Environmental Research and Public Health·Wenhua WangEmilie Dionne
Dec 14, 2018·Health Policy and Planning·Hamid RavaghiVictoria D Bélorgeot
Jul 2, 2019·Health Policy and Planning·Jin Xu, Anne Mills
Aug 9, 2020·International Journal for Equity in Health·Taoyu LinXinping Zhang
Apr 16, 2019·Cost Effectiveness and Resource Allocation : C/E·Jing-Jing ChangZhi-Fang Chen
Aug 29, 2019·Inquiry : a Journal of Medical Care Organization, Provision and Financing·Yu Liu, Richard B Saltman
Jul 7, 2021·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Dongmei MuYuewei Li
Aug 13, 2021·Sociology of Health & Illness·Ross Millar

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