Cost Convergence Between Public and For-profit Hospitals Under Prospective Payment and High Competition in Taiwan

Overview

Journal Health Serv Res

Specialty Health Services

Date 2004 Nov 17

PMID 15544646

Citations 6

Authors

Sudha Xirasagar

Herng-Ching Lin

Affiliations

Soon will be listed here.

Abstract

Objective: To test the hypotheses that: (1) average adjusted costs per discharge are higher in high-competition relative to low-competition markets, and (2) increased competition is associated with cost convergence between public and for-profit (FP) hospitals for case payment diagnoses, but not for cost-plus reimbursed diagnoses.

Data Sources: Taiwan's National Health Insurance database; 325,851 inpatient claims for cesarean section, vaginal delivery, prostatectomy, and thyroidectomy (all case payment), and bronchial asthma and cholelithiasis (both cost-based payment).

Study Design: Retrospective population-based, cross-sectional study.

Data Analysis: Diagnosis-wise regression analyses were done to explore associations between cost per discharge and hospital ownership under high and low competition, adjusted for clinical severity and institutional characteristics.

Principal Findings: Adjusted costs per discharge are higher for all diagnoses in high-competition markets. For case payment diagnoses, the magnitudes of adjusted cost differences between public and FP hospitals are lower under high competition relative to low competition. This is not so for the cost-based diagnoses.

Conclusions: We find that the empirical evidence supports both our hypotheses.

Citing Articles

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Lan T, Pan J Inquiry. 2020; 57:46958020971403.

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Caesarean section in uninsured women in the USA: systematic review and meta-analysis.

Hoxha I, Braha M, Syrogiannouli L, Goodman D, Juni P BMJ Open. 2019; 9(3):e025356.

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Association of High-Volume Surgeons Working in High-Volume Hospitals with Cost of Free Flap Surgeries.

Mahmoudi E, Lu Y, Chang S, Lin C, Wang Y, Chang C Plast Reconstr Surg Glob Open. 2017; 5(10):e1520.

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Risk Factors for 30-Day Unplanned Readmission and Major Perioperative Complications After Spine Fusion Surgery in Adults: A Review of the National Surgical Quality Improvement Program Database.

Su A, Habermann E, Thomsen K, Milbrandt T, Nassr A, Larson A Spine (Phila Pa 1976). 2016; 41(19):1523-1534.

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PMID: 23226447 PMC: 3511433. DOI: 10.1371/journal.pone.0051004.

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