The impact of hospital competition on healthcare quality: evidence from China’s healthcare reform
IntroductionHospital 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 re...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1543884/full |
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| author | Huimin Liu Junyan Jiang Liangchun Yu Xianpeng Liu |
| author_facet | Huimin Liu Junyan Jiang Liangchun Yu Xianpeng Liu |
| author_sort | Huimin Liu |
| collection | DOAJ |
| description | IntroductionHospital 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.MethodsThis 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.ResultsThis 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.ConclusionThe 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. |
| format | Article |
| id | doaj-art-a33c977ec77e4f2384e775952a8d04e8 |
| institution | OA Journals |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-a33c977ec77e4f2384e775952a8d04e82025-08-20T02:34:50ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-05-011310.3389/fpubh.2025.15438841543884The impact of hospital competition on healthcare quality: evidence from China’s healthcare reformHuimin Liu0Junyan Jiang1Liangchun Yu2Xianpeng Liu3School of Economics and Management, Jiangxi University of Science and Technology, Ganzhou, ChinaSchool of Economics, Shandong University, Jinan, ChinaSchool of Economics, Shandong University, Jinan, ChinaCollege of Architecture and Design, Jiangxi University of Science and Technology, Ganzhou, ChinaIntroductionHospital 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.MethodsThis 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.ResultsThis 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.ConclusionThe 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.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1543884/fullhospitalcompetitiontechnical healthcare qualitynon-technical healthcare qualityhealthcare reform in Chinasustainable development goals |
| spellingShingle | Huimin Liu Junyan Jiang Liangchun Yu Xianpeng Liu The impact of hospital competition on healthcare quality: evidence from China’s healthcare reform Frontiers in Public Health hospital competition technical healthcare quality non-technical healthcare quality healthcare reform in China sustainable development goals |
| title | The impact of hospital competition on healthcare quality: evidence from China’s healthcare reform |
| title_full | The impact of hospital competition on healthcare quality: evidence from China’s healthcare reform |
| title_fullStr | The impact of hospital competition on healthcare quality: evidence from China’s healthcare reform |
| title_full_unstemmed | The impact of hospital competition on healthcare quality: evidence from China’s healthcare reform |
| title_short | The impact of hospital competition on healthcare quality: evidence from China’s healthcare reform |
| title_sort | impact of hospital competition on healthcare quality evidence from china s healthcare reform |
| topic | hospital competition technical healthcare quality non-technical healthcare quality healthcare reform in China sustainable development goals |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1543884/full |
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