Is There a Difference in the Utilisation of Inpatient Services Between Two Typical Payment Methods of Health Insurance? Evidence from the New Rural Cooperative Medical Scheme in China

International Journal of Environmental Research and Public Health

Di Jiang¹  Shihan Lei¹  Dai Su¹  Jingjing Chang¹  Min Tan¹  Haomiao Li¹  Yingchun Chen¹  Zhifang Chen¹  Hongxia Gao¹  Xiaomei Hu¹ 

[1] School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China;

关键词: difference;    utilisation of inpatient services;    payment method;    new rural cooperative medical scheme;    interrupted time-series analysis;    propensity score matching;    China;   

DOI  :  10.3390/ijerph16081410

来源: DOAJ

【 摘 要 】

This study aimed to evaluate the effects of the differences between two typical payment methods for the new rural cooperative medical scheme (NRCMS) in China on the utilisation of inpatient services. Interrupted time-series analysis (ITSA) and propensity score matching (PSM) were used to measure the difference between two typical payment methods for the NRCMS with regard to the utilisation of inpatient services. After the reform was formally implemented, the level and slope difference after reform compared with pre-intervention (distribution of inpatients in county hospitals (DIC), distribution of inpatients in township hospitals (DIT) and the actual compensation ratio of inpatients (ARCI)) were not statistically significant. Kernel matching obtained better results in reducing the mean and median of the absolute standardised bias of covariates of appropriateness of admission (AA), appropriateness of disease (AD). The difference in AA and AD of the matched inpatients between two groups was −0.03 (p-value = 0.042, 95% CI: −0.08 to 0.02) and 0.21 (p-value < 0.001, 95% CI: −0.17 to 0.25), respectively. The differences in the utilisation of inpatient services may arise owing to the system designs of different payment methods for NRCMS in China. The causes of these differences can be used to guide inpatients to better use medical services, through the transformation and integration of payment systems.

【 授权许可】

Unknown