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

Li Xiang, Zhengdong Zhong and Junnan Jiang ()
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Li Xiang: School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China
Zhengdong Zhong: School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China
Junnan Jiang: School of Public Administration, Zhongnan University of Economics and Law, 182th South Lake Avenue, Wuhan 430073, China

IJERPH, 2022, vol. 19, issue 23, 1-11

Abstract: 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.

Keywords: regional global budget; floating payment system; response of different-levels hospitals; transferring costs (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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