Comparison of the market share of public and private hospitals under different Medical Alliances: an interrupted time-series analysis in rural China

• Published in: BMC health services research 2024-04, Vol.24 (1), p.496-496, Article 496
• Main Authors: Xiong, Yingbei, Lin, Kunhe, Yao, Yifan, Zhong, Zhengdong, Xiang, Li
• Format: Article
• Language: English
• Subjects: Alliances; China; Comparative analysis; Disposable income; Expenditures; Health care industry; Health care policy; Health Care Reform; Health equity; Hospitals; Hospitals, Private - economics; Hospitals, Private - statistics & numerical data; Hospitals, Public - statistics & numerical data; Humans; Indigent care; Interrupted Time Series Analysis; Market share; Market shares; Medical alliances (MAs); Medical personnel; Per capita; Public health; Public private partnerships; Public-private partnership; Public-Private Sector Partnerships
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-024-10941-0

China initiated the Medical Alliances (MAs) reform to enhance resource allocation efficiency and ensure equitable healthcare. In response to challenges posed by the predominance of public hospitals, the reform explores public-private partnerships within the MAs. Notably, private hospitals can now participate as either leading or member institutions. This study aims to evaluate the dynamic shifts in market share between public and private hospitals across diverse MAs models. Data spanning April 2017 to March 2019 for Dangyang County's MA and January 2018 to December 2019 for Qianjiang County's MA were analyzed. Interrupted periods occurred in April 2018 and January 2019. Using independent sample t-tests, chi-square tests, and interrupted time series analysis (ITSA), we compared the proportion of hospital revenue, the proportion of visits for treatment, and the average hospitalization days of discharged patients between leading public hospitals and leading private hospitals, as well as between member public hospitals and member private hospitals before and after the reform. After the MAs reform, the revenue proportion decreased for leading public and private hospitals, while member hospitals saw an increase. However, ITSA revealed a notable rise trend in revenue proportion for leading private hospitals (p