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The effect of outpatient dialysis global budget cap on healthcare utilization by end-stage renal disease patients

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  • Chang, Ray-E.
  • Hsieh, Chi-Jeng
  • Myrtle, Robert C.

Abstract

Controlling the cost of chronic diseases remains one of the vexing problems of developed and developing nations alike. Taiwan, faced with rapidly escalating healthcare costs associated with End Stage Renal Disease (ESRD) services utilization, imposed an outpatient dialysis global budget (ODBG) on outpatient dialysis care. This study, using a before and after study design with a comparison group, assessed the impact of this policy innovation on outpatient, inpatient and emergency room utilization. Using a difference in difference (DID) strategy and the generalized estimating equation (GEE) approach, this study found providers responded to these changes through cost reduction and revenue enhancement strategies. This study extends our understanding of provider responses to changes in reimbursement policies that target one segment of the continuum of care required by chronic disease patients.

Suggested Citation

  • Chang, Ray-E. & Hsieh, Chi-Jeng & Myrtle, Robert C., 2011. "The effect of outpatient dialysis global budget cap on healthcare utilization by end-stage renal disease patients," Social Science & Medicine, Elsevier, vol. 73(1), pages 153-159, July.
    • Handle: RePEc:eee:socmed:v:73:y:2011:i:1:p:153-159
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    Cited by:

    1. Ren-Yeong Huang & Yuh-Feng Lin & Sen-Yeong Kao & Yi-Shing Shieh & Jin-Shuen Chen, 2014. "A Retrospective Case-Control Analysis of the Outpatient Expenditures for Western Medicine and Dental Treatment Modalities in CKD Patients in Taiwan," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-9, February.
    2. Hung-pin Lai & Meng-Chi Tang, 2018. "Hospital efficiency under global budgeting: evidence from Taiwan," Empirical Economics, Springer, vol. 55(3), pages 937-963, November.
    3. Lin, Lee-Kai, 2022. "Effects of a global budget payment scheme on medical specialty workforces," Social Science & Medicine, Elsevier, vol. 309(C).

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