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The double-edged sword of corporatisation in the hospital sector: evidence from Indonesia

Published online by Cambridge University Press:  15 September 2016

Asri Maharani*
Affiliation:
Department of Public Health, Medical Faculty, University of Brawijaya, Malang, Indonesia Cathie Marsh Institute for Social Research, University of Manchester, Manchester, UK
Gindo Tampubolon
Affiliation:
Cathie Marsh Institute for Social Research, University of Manchester, Manchester, UK
*
*Correspondence to: Asri Maharani, Humanities Bridgeford Street Building, 2nd floor, Oxford Road, Manchester M13 9PL, UK. Email: asri.maharani@postgrad.manchester.ac.uk

Abstract

Hoping to improve their health system performance, many countries have corporatised their hospitals in the past 20 years. What this means for hospital performance remains as yet largely unknown. This study looks into the association of corporatisation and hospital performance in Indonesia. We apply panel data regression analysis to survey data on 54 public hospitals in East Java province. Our analysis suggests that corporatisation is associated with higher hospital income and expenditure, but fails to improve efficiency and equity. These findings suggest that hospital corporatisation policy in Indonesia should increase emphasis on efficiency and equity rather than on financial performance alone.

Type
Articles
Copyright
© Cambridge University Press 2016 

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References

Awofeso, N., Rammohan, A. and Asmaripa, A. (2013), ‘Exploring Indonesia’s low hospital bed utilization-low bed occupancy-high disease burden paradox’, Journal of Hospital Administration, 2(1): 4958.CrossRefGoogle Scholar
Berman, P. A. and Bossert, T. J. (2000), A decade of health sector reform in developing countries: what have we learned?, Data Decision Making Project, International Health Systems Group, Harvard School of Public Health, Washington, DC.Google Scholar
Bossert, T. (1998), ‘Analysing the decentralization of health systems in developing countries: decision space, innovation and performance’, Social Science & Medicine, 47(10): 15131527.Google Scholar
Bossert, T., Chitah, M. B. and Bowser, D. (2003), ‘Decentralization in Zambia: resource allocation and district performance’, Health Policy and Planning, 18(4): 357369.Google Scholar
Bossert, T., Kosen, S., Harsono, B. and Gani, A. (1997), Hospital autonomy in Indonesia, Data for Decision Making Project, Department of Population and International Health, Harvard School of Public Health, Cambridge, MA.Google Scholar
Bossert, T. J. and Mitchell, A. D. (2011), ‘Health sector decentralization and local decision-making: decision space, institutional capacities and accountability in Pakistan’, Social Science & Medicine, 72: 3948.Google Scholar
Bossert, T. J. and Beauvais, J. C. (2002), ‘Decentralization of health systems in Ghana, Zambia, Uganda and the Philippines: a comparative analysis of decision space’, Health Policy and Planning, 17(1): 1431.CrossRefGoogle ScholarPubMed
Braithwaite, J., Travaglia, J. F. and Corbet, A. (2011), ‘Can questions of the privatization and corporatization, and the autonomy and accountability of public hospitals, ever be resolved?’, Health Care Analysis, 19: 133153.Google Scholar
Corden, S. (2003), ‘Autonomous Hospitals Become a Commercial Network: Hospital Rationalization in Victoria, Australia’, in A. S. Preker and A. Harding (eds), Innovations in Health Service Delivery: The Corporatization of Public Hospitals, Washington, DC: The World Bank, 345390.Google Scholar
Gani, A. (1996), ‘Improving quality in public sector hospitals in Indonesia’, International Journal of Health Planning and Management, 11: 275296.Google Scholar
Government of Indonesia (1991), Precidential Decree No.38, Government of Indonesia, Indonesia.Google Scholar
Government of Indonesia (2005), Regulation of Government of Indonesia number 23 and 24 on Guideline of Badan Layanan Umum Financial Management, Indonesia.Google Scholar
Gujarati, D. (2011), Econometrics by Example, London: Palgrave Macmillan.Google Scholar
Hawkins, L., Srisasalux, J. and Osornprasorp, S. (2009), Devolution of health centres and hospital autonomy in Thailand: A rapid assessment, Report from HSRI and World Bank No. 65019, World Bank, Washington, DC.Google Scholar
Hussein, R. H. T., Al-Junid, S., Nyunt-U, S., Baba, Y. and Geyndt, W. D. (2003), ‘Corporatization of a Single Facility: reforming the Malaysian National Heart Institute’, in A. S. Preker and A. Harding (eds), Innovations in Health Service Delivery: The Corporatization of Public Hospitals, Washington, DC: The World Bank, 425450.Google Scholar
Jakab, M., Preker, A., Harding, A. and Hawkins, L. (2002), The Introduction of Market Forces in the Public Hospital Sector: From New Public Sector Management to Organizational Reform, Washington, DC: The World Bank.Google Scholar
Lieberman, S. S. and Alkatiri, A. (2003), ‘Autonomization in Indonesia: The Wrong Path to Reduce Hospital Expenditures’, in A. S. Preker and A. Harding (eds), Innovations in Health Service Delivery: The Corporatization of Public Hospitals, Washington, DC: The World Bank, 511532.Google Scholar
London, J. D. (2013), ‘The promises and perils of hospital autonomy: reform by decree in Vietnam’, Social Science & Medicine, 96: 232240.CrossRefGoogle Scholar
Maharani, A., Femina, D. and Tampubolon, G. (2015), ‘Decentralisation in Indonesia: lessons from cost recovery rate of district hospitals’, Health Policy and Planning, 30:718727.Google Scholar
Mills, A. (1990a), ‘The economics of hospitals in developing countries. Part I: expenditure patterns’, Health Policy and Planning, 5(2): 107117.CrossRefGoogle Scholar
Mills, A. (1990b), ‘The economics of hospitals in developing countries. Part II: cost and sources of income’, Health Policy and Planning, 5(3): 203218.CrossRefGoogle Scholar
Ministry of Health (1995), Guideline for proposing and managing the vertical unit Swadana hospital, Ministry of Health, Indonesia.Google Scholar
Ministry of Health (2010), Regulation of Ministry of Health No. 482/MENKES/PER/IV/2010, Ministry of Health, Indonesia.Google Scholar
Ministry of Health (2013), Regulation of Ministry of Health of Indonesia number 12 on Guideline of Tariffs of Public Hospitals as Badan Layanan Umum, Indonesia.Google Scholar
Organization for Economic Cooperation and Development (OECD) (2010), Value for Money in Health Spending, Paris: OECD.Google Scholar
Phua, K. H. (2003), ‘Attacking Hospital Performance on Two Fronts: Network Corporatization and Financing Reforms in Singapore’, in A. S. Preker and A. Harding (eds), Innovations in Health Service Delivery: The Corporatization of Public Hospitals, Washington, DC: The World Bank, 451484.Google Scholar
Preker, A. S. and Harding, A. (2003), Innovations in Health Service Delivery: The Corporatization of Public Hospitals, Washington, DC: The World Bank.CrossRefGoogle Scholar
Rokx, C., Schieber, G., Harimurti, P., Tandon, A. and Somanathan, A. (2009), Health Financing in Indonesia: A Reform Road Map, Washington, DC: The World Bank.Google Scholar
Scott, G., McKenzie, L. and Webster, J. (2003), ‘Maladjustments in the Corporatization Model: Hospital Reform in New Zealand’, in A. S. Preker and A. Harding (eds), Innovations in Health Service Delivery: The Corporatization of Public Hospitals, Washington, DC: The World Bank, 305344.Google Scholar
Singer, J. D. (2003), Applied Longitudinal Data Analysis: Modeling Change and Event Occurrence, Oxford: Oxford University Press.Google Scholar
Suwandono, A., Gani, A., Purwani, S., Blas, E. and Brugha, R. (2001), ‘Cost recovery beds in public hospitals in Indonesia’, Health Policy and Planning, 16(2): 1018.CrossRefGoogle ScholarPubMed
Vienazindiene, M. and Ciarniene, R. (2007), ‘New public management: theoretical and practical aspects’, Engineering Economics, 5(55): 4451.Google Scholar
World Bank (2010), New Insights into the Provision of Health Services in Indonesia: A Health Workforce Study, Washington, DC: The World Bank.Google Scholar
Yip, W. C. and Hsiao, W. C. (2003), ‘Autonomizing a Hospital System: Corporate Control by Central Authorities in Hong Kong’, in A. S. Preker and A. Harding (eds), Innovations in Health Service Delivery: The Corporatization of Public Hospitals, Washington, DC: The World Bank, 391424.Google Scholar
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