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American Journal of Medical Quality, Vol. 21, No. 1, 68-75 (2006)
DOI: 10.1177/1062860605283618
© 2006 American College of Medical Quality

Quality Competition Among Hospitals: The Effects of Perceived Quality and Perceived Expensiveness on Health Care Consumers

Shou-Hsia Cheng, PhD

Graduate Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC; Room 1515, No. 1, Sec. 1, Jen-Ai Road, Taipei, 100shcheng{at}ha.mc.ntu.edu.tw

Yu-Jung Wei, MS

Graduate Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC

Hong-Jen Chang, MD, MPH, MS

Bureau of National Health Insurance, Department of Health, Executive Yuan, Taiwan, ROC

Quality of care rather than price is the main concern in health care. However, does price notmatter at all? To investigatewhat quality and cost factors influence whether patients perceive health care services as expensive and will recommend a hospital to other patients, the authors analyzed data from a national survey of patients in Taiwan in 2002. A total of 6725 subjects returned questionnaires. Results from logistic regression models showed that (1) a patient's perception of expensiveness was determined simultaneously with the perceived quality and the outofpocket price of care, (2) a patient's perception of hospital quality appeared to be themost important determinant for recommending ahospital, and(3) while the out-of-pocket price did not affect a patient's recommendation, the perceived expensiveness of the services did. The perceived value rather than the price itself-is the essence of quality competition in Taiwan's health care market.

Key Words: quality of care • price • patient perspective • health care market • Taiwan


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