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Markets for hospital services in Zambia
Author(s) -
Nakamba Pamela,
Hanson Kara,
McPake Barbara
Publication year - 2002
Publication title -
the international journal of health planning and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.672
H-Index - 41
eISSN - 1099-1751
pISSN - 0749-6753
DOI - 10.1002/hpm.673
Subject(s) - equity (law) , competition (biology) , market competition , business , market structure , government (linguistics) , service (business) , quality (philosophy) , economics , market economy , industrial organization , marketing , political science , ecology , law , biology , linguistics , philosophy , epistemology
Abstract Hospital reforms involving the introduction of measures to increase competition in hospital markets are being implemented in a range of low and middle‐income countries. However, little is understood about the operation of hospital markets outside the USA and the UK. This paper assesses the degree of competition for hospital services in two hospital markets in Zambia (Copperbelt and Midlands), and the implications for prices, quality and efficiency. We found substantial differences among different hospital types in prices, costs and quality, suggesting that the hospital service market is a segmented market. The two markets differ significantly in their degree of competition, with the high cost inpatient services market in Copperbelt relatively more competitive than that in the Midlands market. The implications of these differences are discussed in terms of the potential for competition to improve hospital performance, the impact of market structure on equity of access, and how the government should address the problem of the mine hospitals. Copyright © 2002 John Wiley & Sons, Ltd.