The impact of hospital competition on healthcare quality
Evidence from China’s healthcare reform
Bibliographic Data
| ID | 22072175 |
|---|---|
| Authors | Huimin Liu (0000-0003-0933-6371, Jiangxi University of Science and Technology), Junyan Jiang (0000-0002-9914-7242, Shandong University, corresponding author), Liangchun Yu (Shandong University), Xianpeng Liu (0000-0002-3907-8548, Jiangxi University of Science and Technology) |
| Year | 2025 |
| Volume | 13 |
| Pages | 1543884-1543884 |
| Publication date | 2025-05-30 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Frontiers in Public Health (JOURNAL) |
| Journal identifiers | ISSN: 2296-2565 • E-ISSN: 2296-2565 |
| Publisher | Frontiers Media SA (PUBLISHER • CH) |
| DOI | 10.3389/fpubh.2025.1543884 |
| PMID | 40520308 |
| OpenAlex | W4410905450 |
| Language | EN |
| Citations received | 1 |
| References cited | 55 |
Introduction: Hospital competition has been a common feature in healthcare reforms worldwide, yet scant attention has been paid to its impact on healthcare quality in China. This study aims to comprehensively evaluate the impact of hospital competition on healthcare quality under China's healthcare reform. Methods: This study used multiple datasets comprising city-level and individual-level data of 21,974 individuals across 150 districts. We employed a two-way fixed effects model to estimate the impact of hospital competition on healthcare quality. To mitigate endogeneity concerns, we instrumented hospital competition with the inverse of the average distance and average travel time from patients to hospitals and performed the Two-Stage Least Squares methods. Results: This study showed a positive effect of hospital competition on both technical and non-technical healthcare quality. The impact is larger for primary hospitals and inpatient services; it is significantly positive for technical healthcare quality in public hospitals. Additionally, our findings implied that hospital competition affects healthcare income, which in turn affects non-technical healthcare quality, but healthcare income and demand jointly influence the relationship between hospital competition and technical healthcare quality. Conclusion: The finding provides new evidence of the impact of hospital competition on both technical and non-technical healthcare quality in China, highlighting a positive relationship that differs from some previous studies. This evidence offers valuable policy implications on hospital competition and also emphasizes the importance of considering the heterogeneity of hospitals and services in policy-making
Business · China · Economic growth · Economics · Health care · Political science · Global Health Care Issues · Healthcare Policy and Management · Healthcare Systems and Reforms · Medicine
The primary health-care system in China
The Quality of Care
Mortality due to low-quality health systems in the universal health coverage era
Harnessing the privatisation of China's fragmented health-care delivery
Cohort Profile
Strategic human resource management and performance in public hospitals in Ethiopia
The impact of the implementation of hierarchical medical system on population health
Non-technical health care quality and health system responsiveness in middle-income countries
Patient Satisfaction Determinants of Inpatient Healthcare
Does Hospital Competition Harm Inpatient Quality? Empirical Evidence from Shanxi, China
Ten years of China’s new healthcare reform
Reimbursement and hospital competition in China
The Effects of Hospital Competition on Inpatient Quality of Care
The growth of private hospitals and their health workforce in China
Competition and Inequality
Is Hospital Competition Socially Wasteful
A regulação pública da saúde no Estado brasileiro
| Citations per year | 1 |
|---|---|
| Citation span | 2026 - 2026 (1) |
| Highly cited | No |