Determinants of the performance of traditional Chinese medicine clinics in Taiwan

The Response of Different-Levels Public Hospitals to Regional Global Budget with a Floating Payment System: Evidence from China

BACKGROUND

Regional Global Budget with a Floating Payment System (RGB-FPS) is a global budget widely used in medical insurance payments. However, existing studies on hospitals' responses to RGB-FPS have limitations. First, existing studies have paid little attention to RGB-FPS's macro effects. Theoretical studies did not analyze differences between different levels of hospitals. Secondly, studies did not reveal whether RGB-FPS has the same impact on the public-hospital-dominated market.

METHODS

First, we refine the research hypotheses through theoretical analysis. We then test the hypotheses empirically through interrupted time series analysis.

RESULTS

Theoretical analysis found that small hospitals were easier to transfer costs. The empirical analysis found that after RGB-FPS, the proportion of inpatients (PI)and the average times of inpatients in large hospitals increased (p < 0.001), and the proportion of non-reimbursable expenses (PNE) remained stable (p > 0.05). PI in secondary hospitals decreased (p < 0.01), and PNE increased (p < 0.01). PI in the primary hospital decreased (p < 0.05), and PNE increased (p < 0.001).

CONCLUSION

This study verifies theoretically and empirically that large hospitals are easier to increase service volume and small hospitals are easier to transfer costs under the influence of RGB-FPS. Chinese public hospitals' response to RGB-FPS is similar to that of private hospitals.

A Comprehensive Evaluation of China's TCM Medical Service System: An Empirical Research by Integrated Factor Analysis and TOPSIS

Objectives: This paper constructs a comprehensive evaluation index of the traditional Chinese medicine (TCM) medical service system and summarizes the development of TCM medical services in China.

Methods: We chose 31 provinces' TCM hospitals as research objects. The data were obtained from the Health Statistics Yearbook from 2013 to 2018 and from the National Statistics of Chinese Medicine from 2012 to 2017. The approaches to factor analysis and TOPSIS are used in this paper. It is found that the comprehensive evaluation indexes of the TCM medical service system can be divided into 4 first-level indicators and 14 second-level indicators.

Results: The development of the TCM medical service system in China is unbalanced and inadequate. North China and East China are generally superior to Northwest and Southwest China in terms of revenue and expenditure for TCM medical services. The per capita of medical resources in the Southwest and Northwest are stronger than those in Central and South China, but overall medical resources are weaker than those in East China and North China. TCM medical service institutions in East China, South China and Central China have achieved better service results and higher economic benefits with less resource input, which further indicates the efficient allocation of resources and the balanced operation of TCM medical service institutions.

Conclusion: The development of China's TCM medical service system shows the imbalance and inadequacy of “East is strong, West is weak” and “South is superior, North is inferior.”