Use of Guanxi and Other Strategies in Dealing with the Chinese Health Care System
22 Pages Posted: 28 Mar 2013 Last revised: 1 Apr 2013
Date Written: March 24, 2013
Chinese citizens are accustomed to dealing with risk and making choices about how to get things done. Such choices are evident in popular responses to hypothetical situations corresponding to three typical unethical practices in Chinese hospitals: overprescribing medicines not covered by insurance, encouraging patients to take unnecessary diagnostic tests, and taking bribes (“red envelopes” or hong bao) for treatment which has already formally been paid for. Using nationally representative survey data, this study examines public perceptions of the likelihood of encountering these practices in local county or district hospitals as well as preferences between different strategies for dealing with them. We develop and test hypotheses about the social structural determinants of preferred strategies: focussing on urban versus rural contexts, level of development, gender, age, education and income. The conclusion considers the implications of the findings for policies designed to mitigate unethical practices.
Keywords: health care utilization, guanxi, bribery, hongbao, China, incentive structures, unethical practice, connections, overprescribing, unnecessary diagnostic tests
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