Helping Vulnerable Hospitals: Evidence from a Medical Poverty Alleviation Program

Problem definition: Healthcare resources are often distributed unevenly, posing major challenges to the equitable provision of medical services. Governments and nonprofit organizations have initiated programs to support underresourced hospitals, but their effectiveness in improving hospital and physician performance remains unclear. This study addresses this gap by evaluating the impact of China’s medical poverty alleviation program (MPAP) on service efficiency and quality at an underresourced hospital. Methodology/results: We employ a staggered difference-in-differences design with matching to reduce imbalance between treatment and control departments. We find that MPAP significantly improves both efficiency and quality, reducing service time by 7.22% and the seven-day revisit by 3.76%. These gains are especially pronounced among less experienced physicians, physicians with prior experience serving as assistants, and physician-expert pairs with larger experience gaps. Managerial implications: Taken together, our analysis indicates that the benefits of MPAP vary across physicians and departments. These findings have practical implications for the design and implementation of MPAP. Specifically, the program should prioritize pairing external experts with less experienced physicians, assigning local physicians to assistant roles to facilitate hands-on learning, and targeting pairings with sufficiently large experience gaps. In addition, the program should focus on departments with higher technological complexity, greater illness severity, and more demanding diagnostic equipment. Funding: Q. Li acknowledges financial support from the Social Sciences and Humanities Research Council of Canada (SSHRC) Insight Development Grant [Grant 430-2025-01018] and Mr. Dan Einwechter through the Einwechter Center for Supply Chain Management, Wilfrid Laurier University. Z. Cao acknowledges the support from the National Natural Science Foundation of China [Grant 72274132]. W. Gu acknowledges financial support from the National Natural Science Foundation of China [Grants 72542010, 72072010, 72025101 and 72394372]. Z. Cao acknowledges financial support from the National Natural Science Foundation of China [Grant 72274132] and the Natural Science Foundation of Sichuan Province [Grant 2025NSFSC1998]. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2024.1351 .

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Publication Details

Journal
Manufacturing & Service Operations Management
Published
2026-04-29
DOI
https://doi.org/10.1287/msom.2024.1351
Primary Topic
Healthcare Systems and Reforms
Type
article
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article

Helping Vulnerable Hospitals: Evidence from a Medical Poverty Alleviation Program

Zhi Cao, Meng Li, Qiang Li, Wei Gu
Manufacturing & Service Operations Management
Healthcare Systems and Reforms
article

Helping Vulnerable Hospitals: Evidence from a Medical Poverty Alleviation Program

Zhi Cao, Meng Li, Qiang Li, Wei Gu
article en

Abstract

Problem definition: Healthcare resources are often distributed unevenly, posing major challenges to the equitable provision of medical services. Governments and nonprofit organizations have initiated programs to support underresourced hospitals, but their effectiveness in improving hospital and physician performance remains unclear. This study addresses this gap by evaluating the impact of China’s medical poverty alleviation program (MPAP) on service efficiency and quality at an underresourced hospital. Methodology/results: We employ a staggered difference-in-differences design with matching to reduce imbalance between treatment and control departments. We find that MPAP significantly improves both efficiency and quality, reducing service time by 7.22% and the seven-day revisit by 3.76%. These gains are especially pronounced among less experienced physicians, physicians with prior experience serving as assistants, and physician-expert pairs with larger experience gaps. Managerial implications: Taken together, our analysis indicates that the benefits of MPAP vary across physicians and departments. These findings have practical implications for the design and implementation of MPAP. Specifically, the program should prioritize pairing external experts with less experienced physicians, assigning local physicians to assistant roles to facilitate hands-on learning, and targeting pairings with sufficiently large experience gaps. In addition, the program should focus on departments with higher technological complexity, greater illness severity, and more demanding diagnostic equipment. Funding: Q. Li acknowledges financial support from the Social Sciences and Humanities Research Council of Canada (SSHRC) Insight Development Grant [Grant 430-2025-01018] and Mr. Dan Einwechter through the Einwechter Center for Supply Chain Management, Wilfrid Laurier University. Z. Cao acknowledges the support from the National Natural Science Foundation of China [Grant 72274132]. W. Gu acknowledges financial support from the National Natural Science Foundation of China [Grants 72542010, 72072010, 72025101 and 72394372]. Z. Cao acknowledges financial support from the National Natural Science Foundation of China [Grant 72274132] and the Natural Science Foundation of Sichuan Province [Grant 2025NSFSC1998]. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2024.1351 .

Manufacturing & Service Operations Management
Sichuan University (CN), University of Houston (US), Wilfrid Laurier University (CA), University of Science and Technology Beijing (CN)
No poverty
Openalex Percentile: Top 6%
Healthcare Systems and Reforms
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