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Trading quality for quantity? Evidence from patient level data in China
Jinglin Song1, Chen Chen2, Shaoyang Zhao3
1Department of Public Economic System and Policy, School of Public Administration, Southwestern University of Finance and Economics, Chengdu, Sichuan, China.
Plos One
|September 16, 2021
Summary
Increased hospital admissions in China correlate with shorter patient stays and higher mortality rates. This highlights a need to enhance medical service supply and implement tiered healthcare systems.
Area of Science:
- Health Services Research
- Public Health Policy
- Econometrics
Background:
- Hospital overcrowding in China strains medical staff, potentially compromising healthcare quality.
- Understanding the relationship between patient volume and healthcare outcomes is crucial for policy development.
Purpose of the Study:
- To empirically assess the impact of daily hospital admissions on healthcare quality in China.
- To investigate the effects on patient length of stay (LOS) and hospital mortality rates.
- To examine variations in these effects across different hospital tiers.
Main Methods:
- Employed ordinary least squares (OLS) and instrumental variable (IV) regression analyses.
- Utilized daily air quality index as an instrumental variable to address endogeneity.
- Analyzed data from 862,722 patient cases across 517 hospitals in China (2014-2019).
Main Results:
- Higher hospital admissions were associated with decreased length of stay (LOS) and increased hospital mortality.
- The IV method indicated a 6.22% decrease in LOS and a 1.86% increase in mortality per additional admission.
- Secondary hospitals showed the most significant impact, with an 18.60% decrease in LOS and a 6.05% increase in mortality per admission.
Conclusions:
- Findings suggest that increased hospital admissions negatively affect healthcare quality indicators.
- Recommendations include augmenting medical service supply and promoting a hierarchical diagnosis and treatment system in China.
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