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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

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  • 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
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    References listed on IDEAS

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