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Effect of an Integrated Payment System on the Direct Economic Burden and Readmission of Rural Cerebral Infarction Inpatients: Evidence from Anhui, China

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  • 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)

  • 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)

  • 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)

  • 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)

  • 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

Rural China is piloting an integrated payment system, which prepays a budget to a medical alliance rather than a single hospital. This study aims to evaluate the effect of this reform on the direct economic burden and readmission rates of cerebral infarction inpatients. The settlement records of 78,494 cerebral infarction inpatients were obtained from the New Rural Cooperative Medical Scheme (NRCMS) database in Dingyuan and Funan Counties in the Anhui Province. The direct economic burden was estimated by total costs, out-of-pocket expenditures, the out-of-pocket ratio, and the compensation ratio of the NRCMS. Generalized additive models and multivariable linear/logistic regression were applied to measure the changes of the dependent variables along with the year. Within the county, the total costs positively correlated to the year ( β = 313.10 in 2015; 163.06 in 2016). The out-of-pocket expenditures, out-of-pocket ratios, and the length-of-stay positively correlated to the year in 2015 ( β = 105.10, 0.01, and 0.18 respectively), and negatively correlated to the year in 2016 ( β = −58.40, −0.03, and −0.30, respectively). The odds ratios of the readmission rates were less than one within the county (0.70 in 2015; 0.53 in 2016). The integrated payment system in the Anhui Province has considerably reduced the direct economic burden for the rural cerebral infarction inpatients, and the readmission rate has decreased within the county. Inpatients’ health outcomes should be given further attention, and the long-term effect of this reform model awaits further evaluation.

Suggested Citation

  • Haomiao Li & Yingchun Chen & Hongxia Gao & Jingjing Chang & Dai Su & Shihan Lei & Di Jiang & Xiaomei Hu & Min Tan & Zhifang Chen, 2019. "Effect of an Integrated Payment System on the Direct Economic Burden and Readmission of Rural Cerebral Infarction Inpatients: Evidence from Anhui, China," IJERPH, MDPI, vol. 16(9), pages 1-12, May.
  • Handle: RePEc:gam:jijerp:v:16:y:2019:i:9:p:1554-:d:227994
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    References listed on IDEAS

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    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.

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