Does hospital strategic alliance affect the paediatric service capacity of local hospitals? A difference-in-differences econometric analysis
Background Health inequality caused by the scarcity and uneven distribution of paediatric service resources is common worldwide. The hospital strategic alliance may improve paediatric service capacity and health equity, but this hypothesis has not yielded consistent results. Here, we examine the hos...
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| Format: | Article |
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BMJ Publishing Group
2024-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/11/e086626.full |
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| author | Zhanchun Feng Qian Fu Li Zhang Xiaolu Yu Cuiping Xiao Cuili Yang |
| author_facet | Zhanchun Feng Qian Fu Li Zhang Xiaolu Yu Cuiping Xiao Cuili Yang |
| author_sort | Zhanchun Feng |
| collection | DOAJ |
| description | Background Health inequality caused by the scarcity and uneven distribution of paediatric service resources is common worldwide. The hospital strategic alliance may improve paediatric service capacity and health equity, but this hypothesis has not yielded consistent results. Here, we examine the hospital strategic alliance’s effect on local hospitals’ paediatric service capacity.Methods The paediatric monitoring data of 119 local hospitals from 14 cities between 2015 and 2019 were obtained from the Hubei Pediatric Quality Control Center and the Provincial Statistical Yearbook. We employed the difference-in-differences model with multiple periods. The samples were divided into three groups—close cooperation group, loose-knit cooperation group and control group—differentiated by hierarchical clustering based on the implementation of core initiatives. The number of outpatient visits and the number of inpatient visits were used as the outcomes. The ‘available beds’ and the ‘health personnel per 1000 resident population’ were chosen as the control variables.Results The cross-over Treat×Post coefficient was significantly positive at a 1% level in Models 1 and 3, with or without control variables. Specifically, the coefficient for the number of outpatients in Model 2 was significantly positive at the 5% level, supporting Hypothesis H1. Model 4 confirmed a significantly positive cross-over Treat×Post coefficient at a 1% level, and Model 3 showed a larger coefficient than Model 2, indicating greater benefits for the loose-knit cooperation model, supporting Hypothesis H2.Conclusions The hospital strategic alliance enhanced the paediatric service capacity of local hospitals. Furthermore, the close cooperation model appears to be a more effective solution for addressing health inequality caused by the scarcity and uneven distribution of paediatric service resources. |
| format | Article |
| id | doaj-art-ff3db91e2ca74e4b9a3cce582c1cf7da |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-ff3db91e2ca74e4b9a3cce582c1cf7da2025-01-28T12:55:09ZengBMJ Publishing GroupBMJ Open2044-60552024-11-01141110.1136/bmjopen-2024-086626Does hospital strategic alliance affect the paediatric service capacity of local hospitals? A difference-in-differences econometric analysisZhanchun Feng0Qian Fu1Li Zhang2Xiaolu Yu3Cuiping Xiao4Cuili Yang5School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaSchool of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, ChinaWuhan Children`s Hospital, Wuhan, Hubei, ChinaWuhan Children`s Hospital, Wuhan, Hubei, ChinaWuhan Children`s Hospital, Wuhan, Hubei, ChinaBackground Health inequality caused by the scarcity and uneven distribution of paediatric service resources is common worldwide. The hospital strategic alliance may improve paediatric service capacity and health equity, but this hypothesis has not yielded consistent results. Here, we examine the hospital strategic alliance’s effect on local hospitals’ paediatric service capacity.Methods The paediatric monitoring data of 119 local hospitals from 14 cities between 2015 and 2019 were obtained from the Hubei Pediatric Quality Control Center and the Provincial Statistical Yearbook. We employed the difference-in-differences model with multiple periods. The samples were divided into three groups—close cooperation group, loose-knit cooperation group and control group—differentiated by hierarchical clustering based on the implementation of core initiatives. The number of outpatient visits and the number of inpatient visits were used as the outcomes. The ‘available beds’ and the ‘health personnel per 1000 resident population’ were chosen as the control variables.Results The cross-over Treat×Post coefficient was significantly positive at a 1% level in Models 1 and 3, with or without control variables. Specifically, the coefficient for the number of outpatients in Model 2 was significantly positive at the 5% level, supporting Hypothesis H1. Model 4 confirmed a significantly positive cross-over Treat×Post coefficient at a 1% level, and Model 3 showed a larger coefficient than Model 2, indicating greater benefits for the loose-knit cooperation model, supporting Hypothesis H2.Conclusions The hospital strategic alliance enhanced the paediatric service capacity of local hospitals. Furthermore, the close cooperation model appears to be a more effective solution for addressing health inequality caused by the scarcity and uneven distribution of paediatric service resources.https://bmjopen.bmj.com/content/14/11/e086626.full |
| spellingShingle | Zhanchun Feng Qian Fu Li Zhang Xiaolu Yu Cuiping Xiao Cuili Yang Does hospital strategic alliance affect the paediatric service capacity of local hospitals? A difference-in-differences econometric analysis BMJ Open |
| title | Does hospital strategic alliance affect the paediatric service capacity of local hospitals? A difference-in-differences econometric analysis |
| title_full | Does hospital strategic alliance affect the paediatric service capacity of local hospitals? A difference-in-differences econometric analysis |
| title_fullStr | Does hospital strategic alliance affect the paediatric service capacity of local hospitals? A difference-in-differences econometric analysis |
| title_full_unstemmed | Does hospital strategic alliance affect the paediatric service capacity of local hospitals? A difference-in-differences econometric analysis |
| title_short | Does hospital strategic alliance affect the paediatric service capacity of local hospitals? A difference-in-differences econometric analysis |
| title_sort | does hospital strategic alliance affect the paediatric service capacity of local hospitals a difference in differences econometric analysis |
| url | https://bmjopen.bmj.com/content/14/11/e086626.full |
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