IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v16y2019i8p1385-d223679.html
   My bibliography  Save this article

Impact of the Global Budget Payment System on Expenditure of Cardiovascular Diseases: An Interrupted Time Series Analysis in Shanghai, China

Author

Listed:
  • Guanshen Dou

    (NHC Key Laboratory of Health Technology Assessment (Fudan University), Department of Health Economics, School of Public Health, Fudan University, Shanghai 200032, China)

  • Yilin Zhang

    (London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK)

  • Yunzhen He

    (NHC Key Laboratory of Health Technology Assessment (Fudan University), Department of Health Economics, School of Public Health, Fudan University, Shanghai 200032, China)

  • Qiaoyun Huang

    (School of Public Health, Kunming Medical University, Kunming 650500, China)

  • Yingfeng Ye

    (NHC Key Laboratory of Health Technology Assessment (Fudan University), Department of Health Economics, School of Public Health, Fudan University, Shanghai 200032, China)

  • Xinyu Zhang

    (NHC Key Laboratory of Health Technology Assessment (Fudan University), Department of Health Economics, School of Public Health, Fudan University, Shanghai 200032, China)

  • Weibing Wang

    (Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China)

  • Xiaohua Ying

    (NHC Key Laboratory of Health Technology Assessment (Fudan University), Department of Health Economics, School of Public Health, Fudan University, Shanghai 200032, China)

Abstract

Since few studies evaluated the impact of the global budget payment system (GBPS) over time, and by expenditure type, this paper aims to evaluate the impact of the GBPS on expenditure of inpatients, and explores how hospitals curb the expenditure in patients with cardiovascular diseases (CVDs) in Shanghai. We built a time series model with the monthly expenditure of CVDs from 2009 to 2012. We evaluated the instant impact and trends impact of the GBPS and analyzed results based on medical expenditure types (e.g., drug, examination, cure, unclassified items), discharge number, and expenditure per capita. We found GBPS instantly dropped the medical expenditure by Chinese Yuan (CNY) 55.71 million ( p < 0.001), and decreased the monthly increasing trend by CNY 4.23 million ( p = 0.011). The discharge number had 10.4% instant reduction and 225.55 monthly decrease ( p = 0.021) while the expenditure per capita experienced fewer changes. Moreover, the expenditure of drug and cure had an instant reduction of CNY 28.31 million and 16.28 million ( p < 0.001). In conclusion, we considered the GBPS is an effective solution to control the expenditure of CVDs by decreasing the discharge number, and a focus on the drug and cure expenditures lead to greater spend reduction than other types of expenditures.

Suggested Citation

  • Guanshen Dou & Yilin Zhang & Yunzhen He & Qiaoyun Huang & Yingfeng Ye & Xinyu Zhang & Weibing Wang & Xiaohua Ying, 2019. "Impact of the Global Budget Payment System on Expenditure of Cardiovascular Diseases: An Interrupted Time Series Analysis in Shanghai, China," IJERPH, MDPI, vol. 16(8), pages 1-14, April.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:8:p:1385-:d:223679
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/16/8/1385/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/16/8/1385/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Godager, Geir & Wiesen, Daniel, 2013. "Profit or patients’ health benefit? Exploring the heterogeneity in physician altruism," Journal of Health Economics, Elsevier, vol. 32(6), pages 1105-1116.
    2. Gao, Chen & Xu, Fei & Liu, Gordon G., 2014. "Payment reform and changes in health care in China," Social Science & Medicine, Elsevier, vol. 111(C), pages 10-16.
    3. Bradley Chen & Victoria Y. Fan, 2015. "Strategic Provider Behavior Under Global Budget Payment with Price Adjustment in Taiwan," Health Economics, John Wiley & Sons, Ltd., vol. 24(11), pages 1422-1436, November.
    4. Ellis, Randall P., 1998. "Creaming, skimping and dumping: provider competition on the intensive and extensive margins1," Journal of Health Economics, Elsevier, vol. 17(5), pages 537-555, October.
    5. Lopreite, Milena & Mauro, Marianna, 2017. "The effects of population ageing on health care expenditure: A Bayesian VAR analysis using data from Italy," Health Policy, Elsevier, vol. 121(6), pages 663-674.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Li Xiang & Zhengdong Zhong & Junnan Jiang, 2022. "The Response of Different-Levels Public Hospitals to Regional Global Budget with a Floating Payment System: Evidence from China," IJERPH, MDPI, vol. 19(23), pages 1-11, November.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Jeannette Brosig‐Koch & Burkhard Hehenkamp & Johanna Kokot, 2017. "The effects of competition on medical service provision," Health Economics, John Wiley & Sons, Ltd., vol. 26(S3), pages 6-20, December.
    2. Pedersen, Line Bjørnskov & Hess, Stephane & Kjær, Trine, 2016. "Asymmetric information and user orientation in general practice: Exploring the agency relationship in a best–worst scaling study," Journal of Health Economics, Elsevier, vol. 50(C), pages 115-130.
    3. Jeannette Brosig‐Koch & Burkhard Hehenkamp & Johanna Kokot, 2023. "Who benefits from quality competition in health care? A theory and a laboratory experiment on the relevance of patient characteristics," Health Economics, John Wiley & Sons, Ltd., vol. 32(8), pages 1785-1817, August.
    4. Lopreite, Milena & Zhu, Zhen, 2020. "The effects of ageing population on health expenditure and economic growth in China: A Bayesian-VAR approach," Social Science & Medicine, Elsevier, vol. 265(C).
    5. Pott, Clara & Stargardt, Tom & Frey, Simon, 2023. "Does prospective payment influence quality of care? A systematic review of the literature," Social Science & Medicine, Elsevier, vol. 323(C).
    6. Victoria Barham & Olga Milliken, 2015. "Payment Mechanisms and the Composition of Physician Practices: Balancing Cost‐Containment, Access, and Quality of Care," Health Economics, John Wiley & Sons, Ltd., vol. 24(7), pages 895-906, July.
    7. Seema Kacker & Tin Aung & Dominic Montagu & David Bishai, 2021. "Providers preferences towards greater patient health benefit is associated with higher quality of care," International Journal of Health Economics and Management, Springer, vol. 21(3), pages 271-294, September.
    8. Allen C. Goodman & Miron Stano, 2000. "Hmos and Health Externalities: A Local Public Good Perspective," Public Finance Review, , vol. 28(3), pages 247-269, May.
    9. Susan J. Méndez & Jongsay Yong & Hugh Gravelle & Anthony Scott, 2024. "Medical pricing decisions: Evidence from Australian specialists," Melbourne Institute Working Paper Series wp2024n11, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne.
    10. Moscone, Francesco & Siciliani, Luigi & Tosetti, Elisa & Vittadini, Giorgio, 2020. "Do public and private hospitals differ in quality? Evidence from Italy," Regional Science and Urban Economics, Elsevier, vol. 83(C).
    11. Kevin E. Pflum, 2015. "Physician Incentives and Treatment Choice," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 24(4), pages 712-751, October.
    12. Barros, Pedro Pita, 2003. "Cream-skimming, incentives for efficiency and payment system," Journal of Health Economics, Elsevier, vol. 22(3), pages 419-443, May.
    13. Caroline S. Carlin & Roger Feldman & Bryan Dowd, 2016. "The Impact of Hospital Acquisition of Physician Practices on Referral Patterns," Health Economics, John Wiley & Sons, Ltd., vol. 25(4), pages 439-454, April.
    14. Alejandro Arrieta & Ariadna García‐Prado & Paula González & José Luis Pinto‐Prades, 2017. "Risk attitudes in medical decisions for others: An experimental approach," Health Economics, John Wiley & Sons, Ltd., vol. 26(S3), pages 97-113, December.
    15. Braendle, Thomas & Colombier, Carsten, 2020. "Budgetary targets as cost-containment measure in the Swiss healthcare system? Lessons from abroad," Health Policy, Elsevier, vol. 124(6), pages 605-614.
    16. Anell, Anders & Dackehag , Margareta & Dietrichson, Jens, 2016. "Does Risk-Adjusted Payment Influence Primary Care Providers' Decision on Where to Set Up Practices?," Working Papers 2016:24, Lund University, Department of Economics.
    17. Miller, Nolan, 2004. "Market Structure, Commitment, and Treatment Incentives in Health Care," Working Paper Series rwp04-007, Harvard University, John F. Kennedy School of Government.
    18. Russell Mannion & Andrew Street, 2009. "Managing activity and expenditure in the new NHS market," Public Money & Management, Taylor & Francis Journals, vol. 29(1), pages 27-34, January.
    19. Hernández-Pizarro, Helena M. & Nicodemo, Catia & Casasnovas, Guillem López, 2020. "Discontinuous system of allowances: The response of prosocial health-care professionals," Journal of Public Economics, Elsevier, vol. 190(C).
    20. Paolo Pertile, 2008. "Investment in Health Technologies in a Competitive Model with Real Options," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 10(5), pages 923-952, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:16:y:2019:i:8:p:1385-:d:223679. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.