IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v16y2019i8p1410-d224267.html
   My bibliography  Save this article

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

Author

Listed:
  • Dai Su

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Yingchun Chen

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Hongxia Gao

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Haomiao Li

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Jingjing Chang

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Shihan Lei

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Di Jiang

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Xiaomei Hu

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Min Tan

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

  • Zhifang Chen

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan 430030, China)

Abstract

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.

Suggested Citation

  • Dai Su & Yingchun Chen & Hongxia Gao & Haomiao Li & Jingjing Chang & Shihan Lei & Di Jiang & Xiaomei Hu & Min Tan & Zhifang Chen, 2019. "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," IJERPH, MDPI, vol. 16(8), pages 1-16, April.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:8:p:1410-:d:224267
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/16/8/1410/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/16/8/1410/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Sebastian Bauhoff & David R. Hotchkiss & Owen Smith, 2011. "The impact of medical insurance for the poor in Georgia: a regression discontinuity approach," Health Economics, John Wiley & Sons, Ltd., vol. 20(11), pages 1362-1378, November.
    2. John Tayu Lee & Fozia Hamid & Sanghamitra Pati & Rifat Atun & Christopher Millett, 2015. "Impact of Noncommunicable Disease Multimorbidity on Healthcare Utilisation and Out-Of-Pocket Expenditures in Middle-Income Countries: Cross Sectional Analysis," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-18, July.
    3. Lingguo Cheng & Hong Liu & Ye Zhang & Ke Shen & Yi Zeng, 2015. "The Impact of Health Insurance on Health Outcomes and Spending of the Elderly: Evidence from China's New Cooperative Medical Scheme," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 672-691, June.
    4. Ning Neil Yu & Xi Zhu, 2018. "Affordable care encourages healthy living: Theory and evidence from China's new cooperative medical scheme," Health Economics, John Wiley & Sons, Ltd., vol. 27(12), pages 2051-2066, December.
    5. Buczak-Stec, Elżbieta & Goryński, Paweł & Nitsch-Osuch, Aneta & Kanecki, Krzysztof & Tyszko, Piotr, 2017. "The impact of introducing a new hospital financing system (DRGs) in Poland on hospitalisations for atherosclerosis: An interrupted time series analysis (2004–2012)," Health Policy, Elsevier, vol. 121(11), pages 1186-1193.
    6. Xiaoyan Lei & Wanchuan Lin, 2009. "The New Cooperative Medical Scheme in rural China: does more coverage mean more service and better health?," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 25-46, July.
    7. Hao‐Miao Li & Ying‐Chun Chen & Hong‐Xia Gao & Yan Zhang & Dai Su & Jing‐Jing Chang & Di Jiang & Xiao‐Mei Hu & Shi‐Han Lei, 2019. "Changes in inpatients' distribution and benefits under institution level–based quota payment for specific diseases in rural China: An interrupted time‐series analysis," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 436-446, January.
    8. Bystrov, Victor & Staszewska-Bystrova, Anna & Rutkowski, Daniel & Hermanowski, Tomasz, 2015. "Effects of DRG-based hospital payment in Poland on treatment of patients with stroke," Health Policy, Elsevier, vol. 119(8), pages 1119-1125.
    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. Wanchun Xu & Zijing Pan & Shan Lu & Liang Zhang, 2020. "Regional Heterogeneity of Application and Effect of Telemedicine in the Primary Care Centres in Rural China," IJERPH, MDPI, vol. 17(12), pages 1-15, June.

    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. Lin, Lin & Zai, Xianhua, 2022. "The Power of Public Insurance With Limited Benefits: Evidence from China's New Cooperative Medical Scheme," GLO Discussion Paper Series 1180, Global Labor Organization (GLO).
    2. repec:dem:wpaper:wp-2022-025 is not listed on IDEAS
    3. Yongqing Dong & Liping Fu & Ronghui Tan & Liman Ding, 2019. "The Dilemma of Medical Reimbursement Policy in Rural China: Spatial Variability between Reimbursement Region and Medical Catchment Area," IJERPH, MDPI, vol. 16(16), pages 1-18, August.
    4. Shen, Ke & Wang, Feng & Cai, Yong, 2016. "Patterns of inequalities in public transfers by gender in China," The Journal of the Economics of Ageing, Elsevier, vol. 8(C), pages 76-84.
    5. Liu, Xiao & Burge, Gregory S., 2024. "The effect of the new cooperative medical scheme on rural labor supply in China," China Economic Review, Elsevier, vol. 85(C).
    6. Jinjing Wu & Shelby Deaton & Boshen Jiao & Zohn Rosen & Peter A Muennig, 2018. "The cost-effectiveness analysis of the New Rural Cooperative Medical Scheme in China," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-13, December.
    7. Fei Xie & Xiaoqing Jiang & Fang Yuan & Xiaoyun Chen & Zhaokang Yuan & Yuanan Lu, 2018. "Impact of the New Cooperative Medical Scheme on the Rural Residents’ Hospitalization Medical Expenses: A Five-Year Survey Study for the Jiangxi Province in China," IJERPH, MDPI, vol. 15(7), pages 1-11, June.
    8. Bairoliya, Neha & Miller, Ray, 2021. "Social insurance, demographics, and rural-urban migration in China," Regional Science and Urban Economics, Elsevier, vol. 91(C).
    9. Yiqiu, Wang & Maria, Porter & Songqing, Jin, 2016. "Estimating Effects of Health Insurance Coverage on Medical Service Utilization and Health in Rural China," 2016 Annual Meeting, July 31-August 2, Boston, Massachusetts 235470, Agricultural and Applied Economics Association.
    10. Conglong Fang & Qingen Gai & Chaofei He & Qinghua Shi, 2020. "The Experience of Poverty Reduction in Rural China," SAGE Open, , vol. 10(4), pages 21582440209, December.
    11. Feiyan Yang & Li Wei, 2023. "The impact of tax-subsidized health insurance on health and out-of-pocket burden in China," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 48(1), pages 194-246, January.
    12. Linglong Ye & Jiecheng Luo & Ben-Chang Shia & Ya Fang, 2019. "Multidimensional Health Groups and Healthcare Utilization Among Elderly Chinese: Based on the 2014 CLHLS Dataset," IJERPH, MDPI, vol. 16(20), pages 1-13, October.
    13. O'Donnell, Owen, 2024. "Health and health system effects on poverty: A narrative review of global evidence," Health Policy, Elsevier, vol. 142(C).
    14. Shen, Menghan & He, Wen & Li, Linyan, 2020. "Incentives to use primary care and their impact on healthcare utilization: Evidence using a public health insurance dataset in China," Social Science & Medicine, Elsevier, vol. 255(C).
    15. Liu, Kai & Prommawin, Benjapon & Schroyen, Fred, 2024. "Health insurance, agricultural production and investments," Journal of Health Economics, Elsevier, vol. 97(C).
    16. Ali, Shehzad & Cookson, Richard & Dusheiko, Mark, 2017. "Addressing care-seeking as well as insurance-seeking selection biases in estimating the impact of health insurance on out-of-pocket expenditure," Social Science & Medicine, Elsevier, vol. 177(C), pages 127-140.
    17. Qing Yang & Qing Xu & Yufeng Lu & Jin Liu, 2020. "The Impact of Public Health Insurance on Household Credit Availability in Rural China: Evidence from NRCMS," IJERPH, MDPI, vol. 17(18), pages 1-17, September.
    18. Guanfu Fang & Xin Li & Tianyu Tang, 2024. "Growing up without health insurance: Evidence from rural China," Health Economics, John Wiley & Sons, Ltd., vol. 33(2), pages 363-390, February.
    19. Bairoliya, Neha & Canning, David & Miller, Ray & Saxena, Akshar, 2018. "The macroeconomic and welfare implications of rural health insurance and pension reforms in China," The Journal of the Economics of Ageing, Elsevier, vol. 11(C), pages 71-92.
    20. Cheng, Lingguo & Liu, Hong & Zhang, Ye & Zhao, Zhong, 2018. "The health implications of social pensions: Evidence from China's new rural pension scheme," Journal of Comparative Economics, Elsevier, vol. 46(1), pages 53-77.
    21. Liu, Hong & Zhao, Zhong, 2014. "Does health insurance matter? Evidence from China’s urban resident basic medical insurance," Journal of Comparative Economics, Elsevier, vol. 42(4), pages 1007-1020.

    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:1410-:d:224267. 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.