The effect of different classification of hospitals on medical expenditure from perspective of classification of hospitals framework: evidence from China

Cost Effectiveness and Resource Allocation

Yanping Hu¹  Tiantian Du²  Lele Li³ 

[1] Department of Medical Engineering, China-Japan Friendship Hospital, 2 Yinghua Yuan, Chaoyang District, Beijing, China;Institute for Hospital Management, Tsinghua University, 1 Tsinghua, Nanshan District, Shenzhen City, Guangdong Province, China;School of Public Policy and Management, Tsinghua University, 1 Tsinghua Yard, Haidian District, Beijing, China;

关键词: Classification of hospitals;    Medical expenditure;    Medical outcome;    multivariate regression model;    Tiered delivery system;   

DOI  :  10.1186/s12962-020-00229-5

来源: Springer

【 摘 要 】

BackgroundDifferent classification of hospitals (COH) have an important impact on medical expenditures in China. The objective of this study is to examine the impact of COH on medical expenditures with the hope of providing insights into appropriate care and resource allocation.MethodsFrom the perspective of COH framework, using the Urban Employee Basic Medical Insurance (UEBMI) data of Chengdu City from 2011 to 2015, with sample size of 488,623 hospitalized patients, our study empirically analyzed the effect of COH on medical expenditure by multivariate regression modeling.ResultsThe average medical expenditure was 5468.86 Yuan (CNY), the average expenditure of drug, diagnostic testing, medical consumables, nursing care, bed, surgery and blood expenditures were 1980.06 Yuan (CNY), 1536.27 Yuan (CNY), 500.01 Yuan (CNY), 166.23 Yuan (CNY), 221.98 Yuan (CNY), 983.18 Yuan (CNY) and 1733.21 Yuan (CNY) respectively. Patients included in the analysis were mainly elderly, with an average age of 86.65 years old. Female and male gender were split evenly. The influence of COH on total medical expenditures was significantly negative (p < 0.001). The reimbursement ratio of UEBMI had a significantly positive (p < 0.001) effect on various types of medical expenditures, indicating that the higher the reimbursement ratio was, the higher the medical expenditures would be.ConclusionsCOH influenced medical expenditures significantly. In consideration of reducing medical expenditures, the government should not only start from the supply side of healthcare services, but also focus on addressing the demand side.

【 授权许可】

CC BY