The Comparative Institutional Analysis (CIA) approach has virtually never been used in theoretical studies of the health care delivery system. This paper seeks to help fill this gap by exploring the explanatory power of such an approach for understanding the change of China’s health care delivery system. It focuses on positive analysis of why China’s urban health care delivery system evolved the way it did.
CIA proposes an analytical-cum-conceptual framework for understanding the nature of institutions as well as their changes. CIA characterizes the institution as sharedbeliefs-cum-equilibrium-summary-representation. It introduces an apparatus, called COASE box, to represent the structures of the game. With subjective game models, CIA focuses on the mechanism of systematic changes in cognition and learning, as well as that in strategic choices made by individual agents and their interactions. It also discusses how the diachronic linkage of institutions may affect the nature and course of their evolution.
CIA, however, is a generic approach of analysis of institutional change. In order to analyze the reform of health care institutions of a transitional country, I will utilize Herder-Dorneich’s model, which provides an analytical frame for health care systems.
With CIA and the Herder-Dorneich model, I set up the subjective game form of every agent of Chinese urban health care system. By discussing how these agents revise their own subjective game forms in response to external shocks in a correlated manner, I attempt to describe the mechanism of Chinese urban health care institutional change.