Assessing the Relationship between Health Care Market Competition and Health Care Quality--- The Impact of the Global Budget Payment System

The National Health Insurance Bureau had replaced the fee-for-services payment scheme with the global budget payment system. The new payment system is likely to increase the competition between hospitals. But how market competition change affects healthcare quality still remains to be clarified. Thus, the two-year study aims to investigate the relationship among market competition, healthcare quality, and the implementation of the global budget payment system. Study population is hospitalized stroke patients between 1997 and 2007. There are two secondary datasets to be utilized, the National Health Insurance Database and the National Hospital and Services Survey. The first-year research objective is to assess the impact of healthcare market competition on healthcare outcome of stroke patients. A pooled cross-sectional time series analysis with fixed effects regression model will be employed. And, the second-year study is to examine the impact of the hospital global budget payment system on healthcare market competition as well as healthcare quality of stroke patients. To achieve the aim, joinpoint regression analysis will be conducted.