Helping Vulnerable Hospitals: Evidence from a Medical Poverty Alleviation Program

贫穷 医疗保健 业务 匹配(统计) 服务(商务) 自然实验 质量(理念) 公共关系 控制(管理) 项目评估 中国 公共经济学 经济增长 卫生服务 社会政策 服务提供商 经济 医疗保健 构造(python库) 卫生政策 干预(咨询) 心理干预 服务质量 医疗保健系统 程序设计语言 政治学 社会福利 医疗服务 人力资源 激励 影响评价 减贫 劳动力发展
作者
Qiang Li,Meng Li,Wei Gu,Zhi Cao
出处
期刊:Manufacturing & Service Operations Management [Institute for Operations Research and the Management Sciences]
标识
DOI:10.1287/msom.2024.1351
摘要

Problem definition: Healthcare resources are often distributed unevenly, posing major challenges to the equitable provision of medical services. Governments and nonprofit organizations have initiated programs to support underresourced hospitals, but their effectiveness in improving hospital and physician performance remains unclear. This study addresses this gap by evaluating the impact of China’s medical poverty alleviation program (MPAP) on service efficiency and quality at an underresourced hospital. Methodology/results: We employ a staggered difference-in-differences design with matching to reduce imbalance between treatment and control departments. We find that MPAP significantly improves both efficiency and quality, reducing service time by 7.22% and the seven-day revisit by 3.76%. These gains are especially pronounced among less experienced physicians, physicians with prior experience serving as assistants, and physician-expert pairs with larger experience gaps. Managerial implications: Taken together, our analysis indicates that the benefits of MPAP vary across physicians and departments. These findings have practical implications for the design and implementation of MPAP. Specifically, the program should prioritize pairing external experts with less experienced physicians, assigning local physicians to assistant roles to facilitate hands-on learning, and targeting pairings with sufficiently large experience gaps. In addition, the program should focus on departments with higher technological complexity, greater illness severity, and more demanding diagnostic equipment. Funding: Q. Li acknowledges financial support from the Social Sciences and Humanities Research Council of Canada (SSHRC) Insight Development Grant [Grant 430-2025-01018] and Mr. Dan Einwechter through the Einwechter Center for Supply Chain Management, Wilfrid Laurier University. Z. Cao acknowledges the support from the National Natural Science Foundation of China [Grant 72274132]. W. Gu acknowledges financial support from the National Natural Science Foundation of China [Grants 72542010, 72072010, 72025101 and 72394372]. Z. Cao acknowledges financial support from the National Natural Science Foundation of China [Grant 72274132] and the Natural Science Foundation of Sichuan Province [Grant 2025NSFSC1998]. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2024.1351 .

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