ArticleInternational journal of environmental research and public health2018
Does Hospital Competition Harm Inpatient Quality? Empirical Evidence from Shanxi, China.
Article in International journal of environmental research and public health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- [The Effect of Service Concentration on Outcome Quality in Obstetrics Departments - An Empirical Analysis of Newborn Mortality in German Hospitals].Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) · 2025Article
- Article
- The impact of hospital competition on healthcare quality: evidence from China's healthcare reform.Frontiers in public health · 2025Article
- The Impact of Hospital Competition on the Quality of Care in Europe: A Systematic Review.Healthcare (Basel, Switzerland) · 2024Review
- Does hospital competition improve the quality of outpatient care? - empirical evidence from a quasi-experiment in a Chinese city.Health economics review · 2024Article
- Heterogeneous effects of hospital competition on inpatient quality: an analysis of five common diseases in China.Health economics review · 2024Article
- What do Iranians value most when choosing a hospital? Evidence from a discrete choice experiment.PloS one · 2024Article
- The Chasm in Percutaneous Coronary Intervention and In-Hospital Mortality Rates Among Acute Myocardial Infarction Patients in Rural and Urban Hospitals in China: A Mediation Analysis.International journal of public health · 2022Article
- Heterogeneous effects of hospital competition on inpatient expenses: an empirical analysis of diseases grouping basing on conditions' complexity and urgency.BMC health services research · 2021Article
- Changes in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015.Open heart · 2021Article
- Director's Perceived Competition and Its Relationship with Hospital's Competitive Behaviors: Evidence from County Hospitals in China.Risk management and healthcare policy · 2021Article
- The Comparison Between Different Hospital Market Definition Approaches: An Empirical Analysis of 11 Representative Diseases in Sichuan Province, China.Frontiers in public health · 2021Article
- The impact of hospital attributes on patient choice for first visit: evidence from a discrete choice experiment in Shanghai, China.Health policy and planning · 2020Article
- Perceived Competition and Process of Care in Rural China.Risk management and healthcare policy · 2020Article
- Does County-Level Medical Centre Policy Influence the Health Outcomes of Patients with Trauma Transported by the Emergency Medical Service System? An Integrated Emergency Model in Rural China.International journal of environmental research and public health · 2019Article
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Authors and funding
8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
This study aimed to determine whether hospital competition is associated with improved in-hospital mortality in Shanxi, China. We included a total of 46,959 hospitalizations for acute myocardial infarction (AMI) and 44,063 hospitalizations for pneumonia from 2015 to 2017. Hospital competition was measured as Herfindahl⁻Hirschman Index based on the patient predicted flow approach. Two-level random-intercept logistic models were applied to explore the effects of hospital competition on quality for both AMI and pneumonia diagnoses. Hospital competition exerts negative or negligible effects on inpatient quality of care, and the pattern of competition effects on quality varies by specific diseases. While hospital competition is insignificantly correlated with lower AMI in-hospital mortality (odds ratio (OR): 0.94, 95% confidence interval (CI): 0.77⁻1.11), high hospital competition was, in fact, associated with higher in-hospital mortality for pneumonia patients (OR: 1.99, 95% CI: 1.51⁻2.64). Our study suggests that simply encouraging hospital competition may not provide effective channels to improve inpatient quality of health care in China's current health care system.
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