Findings suggest that: (1) Public hospitals are turned into state-owned enterprises as they are encouraged to grow into larger size by management autonomy and financial regulatory reform, and the abandonment of the government on the control over management and hospital assets; (2) government abandons its financial responsibility towards public hospital workers and the latter need to use market mechanism to earn their income by cross-reimbursement of price and that devalues professionalism of these workers; (3) government abandons the subsidy to public hospitals through the reform of public hospital financial system; (4) the large higher-tiered public hospitals obtain their preferential rights through political advantageous position; (5) the reform of public hospitals is not at all one dimensional: public hospitals respond by active actions, aggregate breaking of rules and regulations, individual break-through, and no response. In summary, marketization, de-professionalization, diswelfare and market diversification contribute to the reverse triangle model of China's public healthcare system. / Key words: social policy, public hospital, marketization, de-professionalization, discriminated market. / Reform of China's public healthcare system is an extension of China's reform of its social welfare provision system. The above findings provide evidences on the economic rules, social relationships, and government actions in social welfare services as illustrated in the provision of health care by public hospitals in China. It is important reference for decision-makers in the new round of public service reform in the coming future. / Service providers are indispensable components of a social welfare system. Their performance is influenced by government policies and how service providers are active agents. Therefore, attaining the goals of social welfare services needs to consider the institutional arrangements for service providers. / Taking public health service in China as an example, this research answers why the public healthcare provision system in China turns out to be a reverse triangle structure, which is an anti-welfare model suggested by the World Health Organization. With a new institutionalism perspective, policy documents are used to study the effect of government intervention on public hospitals, and the interaction of government and public hospitals. / 馮文. / Submitted: 2010年12月. / Submitted: 2010 nian 12 yue. / Adviser: Chack-kie Wong. / Source: Dissertation Abstracts International, Volume: 73-04, Section: A, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (p. 272-329). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in Chinese and English. / Feng Wen.

The background variables, GDP per capita, marketization, industrialization and urbanization are used to control different levels of development across provinces. The role of the state is measured in the following ways. First, financial capacity, administrative capacity and coercive capacity are used to measure the role of state capacity in BMI extension. The study examines whether there is a difference in choosing different agencies to collect social insurance premiums: one is local taxation agency and the other is social insurance agency. Third, the performance of BMI is measured through the deposit rates of BMI funding which reflects governments' ability to manage the BMI program. In the current policy, employers are charged largely the social insurance fees. So their willingness and capabilities to pay will affect BMI coverage. The study investigates two kinds of employers: loss making State-Owned-Enterprises (SOE hereafter) and Foreign Invested Enterprises (FIE hereafter). On the employee's part, the percent of informal employment in total urban employment is used to measure the effect of adverse employment conditions on BMI coverage. Trade union density is used to estimate the labor organization strength. / The complicated process of extending coverage is related to three major stakeholders: state, employers and employees. These three stake-holders influence BMI progress. Also, the background factors (such as the economic growth) should be taken into account for the regional variations in development level. Since BMI is a typical social policy field, this study reviews major theories about social policy development: logic of industrialism, power resource theory and state-centered approach and so on. These theories help organize pieces of phenomena into a unified framework and testable hypotheses are also derived. / The contributions of this study can be twofold. First, from the theoretical aspect, this research tests several welfare state development theories using Chinese data. In this way, it does not only expand the scope conditions of theories, but also improves our understanding of the social policy development in China, an outlier of traditional western democracies. Second, this study tests some controversial issues on BMI development and the research findings provide knowledge support for the policy practice in the real world. / The low coverage of social health insurance is one of the causes of the problems in Chinese health care system which is criticized for the rising health cost, large share of out-of-pocket payments and health inequality issue. The Basic Medical Insurance for Urban Employees (BMI hereafter) was chosen as the subject of my investigation. It was established in 1998 for the working population and till now it has not achieved universal coverage yet. The Basic Medical Insurance for Urban Residents (BMI-R hereafter) was started in 2007 and it is still in pilot stage, therefore data are still inadequate. In rural areas, the New Cooperative Medical Scheme (NCMS hereafter) achieved almost full coverage in 2008. Thus extending coverage is not issue at concern for NCMS. Besides, the NCMS data at province level are quite limited. Considering the stages of policy development and data access, BMI-R and NCMS are not included in this study. / The proportion of winning lawsuit in labor disputes is used to measure the function of labor protection system. This study adopts the panel method. Data is ranging from the year 1999 to 2005 and the unit of analysis is province/year. They were collected from various official statistics and constructed into a panel database which can trace the development of BMI from its origin to most recent situation. / The research question is what are the determinants of BMI's coverage? It is originated from some puzzling observations: the NCMS achieved full coverage in four years and it is a voluntary participation insurance program. On the contrary, why the mandatory BMI did not reach universal coverage after almost ten years' development? Besides, the progress of BMI across different provinces varied greatly. Given the policy designing and starting points are rather similar, how can we explain these variations? / The research yields several interesting results. First, the roles of financial capacity and administrative capacity in BMI development are supported by data, especially the social insurance agency. Second, results show that using local taxation to collect social insurance premiums has better effects in extending coverage than the alternative approach. This result will give an end to the decade-long debate on choice of social insurance premiums collection agencies. Third, the deposit rates of BMI funding are negatively related with BMI coverage. It implies that governments should improve the performance of BMI so as to attract more people to enroll in this program. Fourth, the union density in the private sector is positively related with BMI coverage. This result disagrees with the conventional wisdom that the Chinese trade unions are useless. It implies that strengthening the organization of employees (even through the official channel) can protect the rights of employees in some degree. / 劉軍強. / Adviser: Cheek-Kie Wong. / Source: Dissertation Abstracts International, Volume: 73-03, Section: A, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (p. 198-222) / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in Chinese and English. / Liu Junqiang.

by Lo Pak Chuen. / Thesis (M.B.A.)--Chinese University of Hong Kong, 1998. / Includes bibliographical references (leaves 141-145). / Questionnaires in Chinese and English. / ABSTRACT --- p.iii / TABLE OF CONTENTS --- p.iv / LIST OF TABLES --- p.vii / LIST OF APPENDICES --- p.viii / ACKNOWLEDGEMENT --- p.ix / Chapter / Chapter I. --- INTRODUCTION --- p.1 / Rise of Consumerism --- p.1 / Consumerism and Health Care Reform --- p.2 / Recreation of Consumer --- p.2 / Consumer Rights - Patient Rights --- p.3 / Global Public Sector Reform --- p.3 / Redefining Citizens --- p.4 / Separation of Providers and Consumers --- p.4 / Participation - Public Participation --- p.5 / Hong Kong Health Care Reform --- p.5 / Establishment of Hospital Authority --- p.5 / Point of Contact: Hospital Authority and Patients --- p.6 / Rise of Patient Oriented Services and Total Quality Management Philosophy --- p.7 / Patients' Charter --- p.8 / Patient Satisfaction Measurement --- p.9 / Hospital Authority Complaint Channels --- p.9 / Public Participation --- p.10 / Purpose of the Study --- p.10 / Local Studies --- p.10 / Business Objectives --- p.11 / Research Objectives --- p.12 / Chapter II. --- METHODOLOGY --- p.13 / Definition of Concepts --- p.13 / Patient Participation --- p.13 / Background --- p.13 / Different Meanings in Different Contexts --- p.14 / Active Process --- p.14 / Attributes of Patient Participation --- p.14 / Relationship --- p.15 / Information Gap --- p.15 / Surrendering of Degree of Power and Control --- p.15 / Intellectual and Physical Attributes --- p.16 / Patient Satisfaction --- p.17 / Background --- p.17 / Theoretical Models of Patient Satisfaction --- p.18 / "Stimuli, Value Judgements, and Reactions" --- p.18 / Perceptual Realities --- p.18 / Intervention in the Patient Satisfaction Process --- p.18 / Individual Differences --- p.19 / Survey Design --- p.20 / Design --- p.20 / Sampling Site --- p.21 / Time --- p.22 / Respondents --- p.22 / Field Work --- p.22 / Questionnaire - Operationalization of Concepts --- p.23 / Patient Participation --- p.23 / Patient Satisfaction --- p.24 / Demographic Data and Hospital Experience --- p.25 / Hypotheses --- p.25 / Chapter III. --- DATA ANALYSIS --- p.26 / Survey Summary --- p.26 / Overview of Patient Satisfaction --- p.26 / Accessibility --- p.27 / Process --- p.27 / Outcomes --- p.28 / Overview of Patient Participation --- p.30 / Relationship --- p.30 / "Narrowing of Information, Knowledge and Competence Gap" --- p.30 / Spend Time to Search for Information --- p.30 / Patient - Health Care Professional Relationship --- p.31 / Knowledge about Patient Resources --- p.33 / Patients' Charter --- p.33 / Familiarity with Complaint Channels --- p.36 / Engagement of Physical and Intellectual Activities --- p.37 / Use Patient Resources --- p.37 / Use Complaint Channels --- p.37 / Public Participation --- p.38 / Revisit Same Hospital and Doctor --- p.39 / Demographic Data --- p.39 / Hospital Experience --- p.42 / Hypothesis - Data Reduction --- p.43 / Factor Analysis --- p.43 / Patient Participation --- p.44 / Patient Satisfaction --- p.48 / Patient Satisfaction Equation --- p.49 / Hypothesis Testing --- p.51 / Patient Participation and Satisfaction --- p.51 / Patient Participation Knowledge --- p.51 / Patient Participation Use --- p.52 / Correlation Studies --- p.53 / Demographic Variables and Participation --- p.53 / Chapter IV. --- IMPLICATIONS --- p.58 / Patient Participation --- p.58 / Relationship --- p.58 / "Narrowing of Information, Knowledge and Competence Gap" --- p.58 / Information Sharing and Decision Making --- p.58 / Opening Channels of Communication --- p.60 / Role of Nurse --- p.60 / Engage in Physical and Intellectual Activities --- p.61 / Promotion of Patients' Charter and Patient Resources --- p.61 / Complaint Channels --- p.61 / Patient Satisfaction --- p.62 / Comparison and Benchmarking --- p.62 / Theoretical Framework Revisited --- p.63 / Participation: Modify Patients' Expectations --- p.65 / Patients as High-Involvement Customers --- p.65 / Modify the Stimuli --- p.66 / Quality --- p.66 / Customer Chain --- p.67 / Chapter V. --- CONCLUSION --- p.68 / Limitations of the Study --- p.69 / Hypothesis Testing --- p.65 / Reliability and Validity --- p.70 / Quantitative Methodology --- p.71 / Scope of Study --- p.71 / APPENDICES --- p.73 / BIBLIOGRAPHY --- p.141

Wong, King Moses. / "August 2010." / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 158-172). / Abstracts in English and Chinese. / Chapter Chapter One: --- Introduction --- p.1 / Chapter 1.1 --- Background --- p.1 / Chapter 1.2 --- Research objectives --- p.5 / Chapter 1.3 --- Research hypothesis --- p.7 / Chapter 1.4 --- Research questions --- p.7 / Chapter 1.5 --- Research structure --- p.9 / Chapter Chapter Two: --- Literature Review --- p.10 / Chapter 2.1 --- "Health geography: knowledge of population, people, places and health" --- p.10 / Chapter 2.2 --- Understanding geographies of diseases: mapping and modeling diseases and health --- p.17 / Chapter 2.3 --- Healthcare services provision and utilization --- p.22 / Chapter 2.4 --- Hong Kong: facts and context --- p.31 / Chapter 2.4.1 --- Demographics --- p.32 / Chapter 2.4.2 --- Key challenges arising from population ageing --- p.37 / Chapter 2.4.2.1 --- Implications to medico-social agenda --- p.38 / Chapter 2.4.2.2 --- Implications to health status --- p.38 / Chapter 2.4.2.3 --- Implications to disease pattern --- p.39 / Chapter 2.4.3 --- Healthcare service delivery system in Hong Kong --- p.41 / Chapter 2.4.3.1 --- Financing and expenditure --- p.42 / Chapter 2.4.3.2 --- Organizational framework and healthcare policy --- p.44 / Chapter 2.4.3.3 --- Healthcare resources --- p.49 / Chapter 2.4.3.4 --- Utilization and provision of public healthcare services --- p.50 / Chapter Chapter Three: --- Material & Methods --- p.55 / Chapter 3.1 --- Background of main source of data --- p.55 / Chapter 3.2 --- Sources of data --- p.57 / Chapter 3.2.1 --- Hospital services utilization data --- p.57 / Chapter 3.2.2 --- Healthcare resources data --- p.61 / Chapter 3.2.3 --- Population data --- p.62 / Chapter 3.3 --- Spatial scale of analysis --- p.62 / Chapter 3.4 --- Statistical analyses --- p.63 / Chapter 3.4.1 --- Service utilization ratios --- p.63 / Chapter 3.4.2 --- Provision of healthcare resources to population --- p.65 / Chapter 3.4.3 --- Adequacy of healthcare services provision --- p.65 / Chapter 3.4.4 --- Mortality analysis --- p.67 / Chapter 3.4.5 --- Multi-level analysis --- p.69 / Chapter 3.4.6 --- Mapping of health services utilization ratio and mortality ratio --- p.70 / Chapter 3.5 --- Statistical packages used --- p.73 / Chapter 3.6 --- Cautions on interpretation --- p.74 / Chapter 3.6.1 --- Confounding and ecological fallacy --- p.74 / Chapter 3.6.2 --- Problem with the use of Standardized Mortality Ratio --- p.75 / Chapter 3.6.3 --- Problem with mapping and visualization --- p.76 / Chapter Chapter Four: --- Results --- p.78 / Chapter 4.1 --- Socio-spatial variation in mortality --- p.78 / Chapter 4.2 --- Statistical analysis and mapping of health services utilization ratio --- p.80 / Chapter 4.3 --- Statistical and cartographic analysis in Standardized Mortality Ratio --- p.88 / Chapter 4.4 --- Provision of healthcare resources to population --- p.91 / Chapter 4.5 --- "Multi-level analysis of hospital services utilization, provision and mortality" --- p.92 / Chapter 4.6 --- Further analysis --- p.95 / Chapter Chapter Five: --- Discussion --- p.100 / Chapter 5.1 --- Geographic variations in health services utilization ratios --- p.101 / Chapter 5.2 --- Geographic variation in Standardized Mortality Ratio --- p.107 / Chapter 5.3 --- "Multi-level models on health services utilization, provision and mortality" --- p.121 / Chapter 5.3.1 --- Socio-demographic characteristics of health services utilization --- p.121 / Chapter 5.3.1.1 --- Age --- p.121 / Chapter 5.3.1.2 --- Gender --- p.124 / Chapter 5.3.2 --- Health services utilization in relation to services provision --- p.129 / Chapter 5.3.3 --- Health services utilization in relation to mortality --- p.132 / Chapter 5.3.4 --- Adequacy of healthcare services provision --- p.134 / Chapter 5.3.4.1 --- Adequacy of hospital care provision --- p.134 / Chapter 5.3.4.2 --- Adequacy of primary care provision --- p.139 / Chapter 5.4 --- Implications --- p.143 / Chapter 5.5 --- Strengths of study --- p.146 / Chapter 5.6 --- Limitations of study --- p.148 / Chapter 5.7 --- Recommendations for future research --- p.151 / Chapter Chapter Six: --- Conclusion --- p.154 / References --- p.158

Indiana University-Purdue University Indianapolis (IUPUI) / In 2008, grassroots NGOs formed 13 alliances in response to the need for emergency relief and post-disaster recovery after the Sichuan Earthquake that occurred in West China and killed approximately 87,000 people. These alliances served to raise and deliver relief materials, train and supervise volunteers, promote information sharing, and assist victims with mental health and livelihood recovery. However, all alliances were terminated within less than four years. Although plenty of scholarship discusses how corporate alliances evolve or fail, few studies focus on interorganizational collaboration among nonprofits. To explore how NGOs developed collective actions in China’s adverse sociopolitical environment, the author performed three years of observation in four coalitions and interviewed 60 alliance leaders, employees, and volunteers. This paper identifies four types of termination these NGO alliances experienced: three of them failed at their very births, five self-disbanded shortly after the end of emergency aid, three dissolved due to failed institutionalization, and the remaining two evolved into independent organizations. Tracking their life cycles, this study finds four main factors accountable for their terminations: political pressure, funding shortage, short-term orientation, and leadership failure. In particular, the repressive NGO regulation regime and limited funding sources fundamentally restricted all alliances’ capacity and sustainability. Further, the transient nature of disaster relief efforts and the conflict between disaster management and planned work areas contributed to the short-term orientation among alliance members and, thus, led to the closure of some alliances shortly after they provided emergency relief. In addition, though generally exempt from internal rivalry that often undermines inter-firm partnerships, NGO alliances of all types were confronted with leadership challenges—partner misfits concerning resources, strategy, and mission; flawed governing structures, and undesired individual leadership. The four factors interplayed and led to alliance dissolution through different combinations. The paper points out that, in addition to environmental uncertainty, leadership failure has become a major challenge for nonprofit collaborations.

Taking into account of the colonial nature of modern Hong Kong, this author is to examine how the TWGHs as a medical space gradually developed from one that used only Chinese medicine into one in which Chinese medicine and western medicine coexisted. However, it finally became a western style hospital using only western medicine in the inpatient services in the 1940s, along with the growing hegemony of western medicine that was underpinned by colonial power. The multidimensional relationships among different agents in the process of transformation of medical services in the TWGHs constitutes another important theme of this thesis. These relationships touched upon a series of significant interactions between colonial government and Chinese community, colonial authorities and the Tung Wah Board of Directors, Chinese and western medical practitioners, Chinese community and the Tung Wah authorities, and so on. / The implantation, dissemination and expansion of modern western medicine, as an important part of western learning that infiltrated into the Orient, exerted profound impacts on Chinese traditional medical patterns and Chinese medical ideas and practices. As the center for exchange between Chinese and Western Culture, Hong Kong became a significant space for the spread and practice of western medicine. A wide range of western medical services and activities were delivered and developed by the colonial government, western missionaries, benevolent societies, and private practitioners in order to promote the development and popularization of western medicine among the Chinese community, including the establishment of hospitals, dispensaries and clinics, the opening of medical schools and training of western doctors, and the promotion of public health education. / This thesis also points out that the early intense prejudice and resistance against western medicine is not necessarily and cannot be entirely attributed to the underlying difference in the concept and practice of healing and sickness in the two different medical systems. Instead, I argue that a number of technical and practical factors in the delivery of western medical services provided by different agencies greatly affected and determined the choices and uses of the Chinese population. At the same time, the gradual recognition and reception of western medicine among the Chinese was not only the passive result of the compulsory western medical system developed by the colonial government, but also an active realization of the real efficiency and value of western medicine among the indigenous population and their consent and acceptance of its ideology and cultural value, to a great extent. / This thesis examines the confrontation and interaction between Chinese medicine and Western medicine, and the diverse and complicated Chinese attitudes towards western medicine by studying the history of the introduction of western medicine into Hong Kong and the case of transformation of Chinese and western medical services in the Tung Wah Group of Hospitals (TWGHs) during the period between 1894 and 1941. The history of the TWGHs dates back to the opening of the Tung Wah Hospital in 1870. Originally intended for the accommodation and treatment of those Chinese who had strong fears and prejudices against western medicine, the Tung Wah Hospital was founded to provide treatment only by Chinese doctors using Chinese medicine. The bubonic plague of 1894 in Hong Kong marked an important turning point in the history of medical services of the Tung Wah Hospital. Since then, western medicine was formally introduced into the Tung Wah Hospital in 1897. / 楊祥銀. / Adviser: Hon-ming Yip. / Source: Dissertation Abstracts International, Volume: 69-02, Section: A, page: 0715. / Thesis (doctoral)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (p. 279-306). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in Chinese and English. / School code: 1307. / Yang Xiangyin.