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学科主题: 公共卫生
题名:
Payment Reform Pilot In Beijing Hospitals Reduced Expenditures And Out-Of-Pocket Payments Per Admission
作者: Jian, Weiyan1; Lu, Ming2; Chan, Kit Yee3; Poon, Adrienne N.4; Han, Wei5; Hu, Mu6; Yip, Winnie5
刊名: HEALTH AFFAIRS
发表日期: 2015-10-01
DOI: 10.1377/hlthaff.2015.0074
卷: 34, 期:10, 页:1745-1752
收录类别: SCI ; SSCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Health Care Sciences & Services ; Health Policy & Services
研究领域[WOS]: Health Care Sciences & Services
关键词[WOS]: MIDDLE-INCOME COUNTRIES ; HEALTH SYSTEMS ; CHINA ; IMPACT
英文摘要:

In 2009 China announced plans to reform provider payment methods at public hospitals by moving from fee-for-service (FFS) to prospective and aggregated payment methods that included the use of diagnosis-related groups (DRGs) to control health expenditures. In October 2011 health policy makers selected six Beijing hospitals to pioneer the first DRG payment system in China. We used hospital discharge data from the six pilot hospitals and eight other hospitals, which continued to use FFS and served as controls, from the period 2010-12 to evaluate the pilot′s impact on cost containment through a difference-in-differences methods design. Our study found that DRG payment led to reductions of 6.2 percent and 10.5 percent, respectively, in health expenditures and out-of-pocket payments by patients per hospital admission. We did not find evidence of any increase in hospital readmission rates or cost shifting from cases eligible for DRG payment to ineligible cases. However, hospitals continued to use FFS payments for patients who were older and had more complications than other patients, which reduced the effectiveness of payment reform. Continuous evidence-based monitoring and evaluation linked with adequate management systems are necessary to enable China and other low- and middle-income countries to broadly implement DRGs and refine payment systems.

语种: 英语
所属项目编号: 12-120
项目资助者: China Medical Board
WOS记录号: WOS:000366723700022
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/60727
Appears in Collections:北京大学公共卫生学院_期刊论文

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作者单位: 1.Peking Univ, Dept Hlth Policy & Management, Sch Publ Hlth, Beijing 100871, Peoples R China
2.Peking Univ, Dept Med Informat, Sch Basic Med, Beijing 100871, Peoples R China
3.Univ Edinburgh, Ctr Global Hlth Res, Usher Inst Populat Hlth Sci & Informat, Edinburgh EH8 9YL, Midlothian, Scotland
4.Univ Oxford, Blavatnik Sch Govt, Oxford OX1 2JD, England
5.Peking Univ, Clin Med Sch 3, Beijing 100871, Peoples R China
6.George Washington Univ, Sch Med & Hlth Sci, Dept Internal Med, Washington, DC 20052 USA

Recommended Citation:
Jian, Weiyan,Lu, Ming,Chan, Kit Yee,et al. Payment Reform Pilot In Beijing Hospitals Reduced Expenditures And Out-Of-Pocket Payments Per Admission[J]. HEALTH AFFAIRS,2015,34(10):1745-1752.
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