Hospital Ownership and Hospital Institutional Change: A Qualitative Study in Guizhou Province, China

Yu Xie, Di Liang, Jiayan Huang and Jiajie Jin
Additional contact information
Yu Xie: School of Public Health, Fudan University/Key Lab of Health Technology Assessment, National Health Commission, Shanghai 200032, China
Jiayan Huang: School of Public Health, Fudan University/Key Lab of Health Technology Assessment, National Health Commission, Shanghai 200032, China
Jiajie Jin: School of Public Health, Fudan University/Key Lab of Health Technology Assessment, National Health Commission, Shanghai 200032, China

IJERPH, 2019, vol. 16, issue 8, 1-14

Abstract: Objectives : To qualitatively compare the influence of different ownership which is considered as a kind of institutional environment in public hospitals, private hospitals, and mixed-ownership hospitals on hospital governance structure and organizational behavior. Design : Qualitative descriptive study, using semi-structured, in-depth interviews and thematic template analysis, theoretically informed by critical realism. Participants : 27 key informants including national policymakers in charge of the health sector, influential researchers, local administrators responsible for implementing policies, and hospital managers who are experienced in institutional change. Results : Hospital ownership has a significant influence on hospitals in terms of decision-making power allocation, residual ownership allocation, market entry level, accountability, and social functions. These five aspects in hospital organizational structure incentivize hospitals to adapt to the internal and external environment of the hospital organization—such as market environment, governance, and financing arrangements—affect the behavior of the hospital organization, and ultimately affect the efficiency of hospital operation and quality of service. The incentives under the public system are relatively distorted. Private hospitals have poor performance in failing their social functions due to their insufficient development ability. Compared to them, mixed ownership hospitals have a better performance in terms of incentive mechanism and organizational development. Conclusion : Public hospitals should improve the governance environment and decision-making structure, so as to balance their implementation of social functions and achieve favorable organizational development. For private hospitals, in addition to the optimization of the policy environment, attempts should be made to strengthen their supervision. The development of mixed-ownership hospitals should be oriented towards socialized governance.

Keywords: property right; ownership; organizational reform; case study; Guizhou; China (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/16/8/1460/pdf (application/pdf)
https://www.mdpi.com/1660-4601/16/8/1460/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:16:y:2019:i:8:p:1460-:d:225635

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().