Has the medical reform improved the cost efficiency of Chinese hospitals?

After three decades of reform, the medical care system in China has experienced significant changes. However, the present research has not made a tentative evaluation of it to justify further reform. This paper analyses the cost efficiency of Chinese hospitals in 31 provinces during the period from 2002 to 2011 and adopts a Bayesian stochastic frontier model taking account of the identified heterogeneity according to the background of Chinese medical system reform, including the coastal location, 3A class hospital proportion, public subsidies and medical insurance reforms. It finds that the public subsidies and medical insurance reforms have improved the cost efficiency of Chinese hospitals, while the coastal location and 3A class hospital proportion have decreased the cost efficiency of Chinese hospitals. Therefore, these results imply that it will be beneficial for Chinese medical system to optimize the fiscal subsidies of public hospitals, encourage the entrance of private hospitals, improve the medical insurance coverage and set up the pre-triage system.

Persistence of airline accidents.

This paper expands on air travel accident research by examining the relationship between air travel accidents and airline traffic or volume in the period from 1927-2006. The theoretical model is based on a representative airline company that aims to maximise its profits, and it utilises a fractional integration approach in order to determine whether there is a persistent pattern over time with respect to air accidents and air traffic. Furthermore, the paper analyses how airline accidents are related to traffic using a fractional cointegration approach. It finds that airline accidents are persistent and that a (non-stationary) fractional cointegration relationship exists between total airline accidents and airline passengers, airline miles and airline revenues, with shocks that affect the long-run equilibrium disappearing in the very long term. Moreover, this relation is negative, which might be due to the fact that air travel is becoming safer and there is greater competition in the airline industry. Policy implications are derived for countering accident events, based on competition and regulation.

An analysis of hospital efficiency and productivity growth using the Luenberger indicator.

We analyze hospital efficiency and productivity growth using an innovative approach which employs the directional distance function and the Luenberger productivity indicator. The primary advantage of our approach is that both input contractions and output expansions are considered. Our model generates a productivity indicator that is decomposed into the usual constituents of productivity growth: technological change and efficiency change. For the sake of comparison, we also use the Malmquist productivity index. The empirical results based on a sample of Portuguese hospitals from 1997 to 2004 show that, on average, those hospitals experienced very weak productivity growth over that period. In addition, the incidence of technological change was remarkably low.