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Activité et performance des hôpitaux municipaux en Chine rurale. Une analyse sur données d'enquêtes dans la province de Shandong

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  • Martine Audibert

    (CERDI - Centre d'Études et de Recherches sur le Développement International - UdA - Université d'Auvergne - Clermont-Ferrand I - CNRS - Centre National de la Recherche Scientifique)

  • Jacky Mathonnat

    (CERDI - Centre d'Études et de Recherches sur le Développement International - UdA - Université d'Auvergne - Clermont-Ferrand I - CNRS - Centre National de la Recherche Scientifique)

  • Yohana Dukhan

    (CERDI - Centre d'Études et de Recherches sur le Développement International - UdA - Université d'Auvergne - Clermont-Ferrand I - CNRS - Centre National de la Recherche Scientifique)

  • Ningshan Chen
  • Aning Ma
  • Aïtian Yin

Abstract

La décentralisation en Chine a placé les hôpitaux municipaux (HM) au cœur du système sanitaire en zone rurale. Nous avons collecté des informations dans un échantillon de 21 HM de la province de Shandong et dans les administrations concernées pour analyser par des méthodes quantitatives les déterminants de leur activité, mesurer leur efficience et en rechercher les facteurs explicatifs pour la période 1986-2000. Nos résultats suggèrent entre autres que le revenu per capita de la zone de desserte des HM et leur attractivité perçue ont un effet positif sur leur activité, que les tarifs pratiqués en sont un frein et que les dispositifs de couverture maladie n'ont pas d'impact significatif sur leur fréquentation. L'intégration verticale partielle des HM avec les centres de santé villageois a relativement freiné l'activité de ces hôpitaux. Leur efficience s'est globalement améliorée, selon une dynamique relativement hétérogène, durant la période étudiée, mais on observe une certaine convergence des performances. Cette évolution s'est faite en partie sous l'influence de facteurs institutionnels qui tiennent à des modalités de régulation sectorielle et à des questions de gouvernance liées aux relations entre les HM et la tutelle.

Suggested Citation

  • Martine Audibert & Jacky Mathonnat & Yohana Dukhan & Ningshan Chen & Aning Ma & Aïtian Yin, 2008. "Activité et performance des hôpitaux municipaux en Chine rurale. Une analyse sur données d'enquêtes dans la province de Shandong," Post-Print hal-00276226, HAL.
    • Handle: RePEc:hal:journl:hal-00276226
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    Cited by:

    1. Martine Audibert & Xiao Xian Huang & Jacky Mathonnat & Aurore Pelissier & Anning Ma, 2012. "Health Insurance Reform and Efficiency of Township Hospitals in Rural China: An Analysis from Survey Data," CERDI Working papers halshs-00587799, HAL.
    2. Audibert, Martine & Mathonnat, Jacky & Pelissier, Aurore & Huang, Xiao Xian & Ma, Anning, 2013. "Health insurance reform and efficiency of township hospitals in rural China: An analysis from survey data," China Economic Review, Elsevier, vol. 27(C), pages 326-338.
    3. Martine Audibert & Yong He & Jacky Mathonnat, 2011. "Income Growth, Price Variation and Health Care Demand: A Mixed Logit Model Applied to Tow-period Comparison in Rural China," CERDI Working papers halshs-00552192, HAL.
    4. Martine Audibert & Yong He & Jacky Mathonnat, 2013. "Two-Period Comparison of Healthcare Demand with Income Growth and Population Aging in Rural China: Implications for Adjustment of the Healthcare Supply and Development," CERDI Working papers halshs-00846088, HAL.
    5. Martine Audibert & Yong He & Jacky Mathonnat, 2013. "Two-Period Comparison of Healthcare Demand with Income Growth and Population Aging in Rural China: Implications for Adjustment of the Healthcare Supply and Development," Working Papers halshs-00846088, HAL.
    6. Martine AUDIBERT & Jacky MATHONNAT & Yong HE, 2010. "Income Growth, Price Variation and Health Care Demand: A Mixed Logit Model Applied to Tow-period Comparison in Rural China," Working Papers 201035, CERDI.
    7. Esso-hanam Atake, 2015. "Technical efficiency of public hospitals in Togo: A directional distance function approach," Economics Bulletin, AccessEcon, vol. 35(3), pages 1752-1764.

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