Intensity response of Thai public hospitals to payment system change Online publication date: Sun, 11-Jan-2015
by Watchai Charunwatthana; Siripen Supakankunti
International Journal of Economic Policy in Emerging Economies (IJEPEE), Vol. 7, No. 4, 2014
Abstract: Hospital responses on service intensity could be affected by payment system change from fee-for-service to DRG-based basis for CSMBS patients. This study aims: 1) to examine overall intensity effect of payment change on the average length of stay (LOS); 2) to decompose overall effect into the moral hazard, selection and practice-style effects. Descriptive statistics and regression technique were conducted. The findings showed negative intensity response to policy changes through a decrease in the average LOS for CSMBS patients by 0.23 days in aggregate and at the regional, general and community hospitals by 0.30, 0.29 and 0.15 days respectively. The regression analysis revealed the negative moral hazard effects at the regional and general hospitals and positive selection effects at all levels of hospitals. There is also positive practice-style effect. It implies that Thai public hospitals behave according to Hodgkin and McGuire's model.
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