ArticleBMC pregnancy and childbirth2018
Caesarean section rate and cost control effectiveness of case payment reform in the new cooperative medical scheme for delivery: evidence from Xi County, China.
Article in BMC pregnancy and childbirth, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effects of different payment methods on perinatal care outcomes: a systematic review.BMC health services research · 2025Pooled it
- The effectiveness of financial intervention strategies for reducing caesarean section rates: a systematic review.BMC public health · 2019Pooled it
- Can DRG payment under global budget with price adjustment curb the soaring healthcare costs? Insights from China's reform and its underlying mechanism.BMC public health · 2025Article
- Rising C-section use and the private maternal health care sector in Pakistan: evidence from the 2012-13 and 2017-18 Demographic and Health Surveys.BMC pregnancy and childbirth · 2025Article
- A scoping review of Chinese national policies to promote the three-medicals linkage reform since 2014.npj health systems · 2025Article
- Evaluating the impact of the diagnosis-related groups payment system on laparoscopic uterine fibroid surgery outcomes: insights from a single-center study.Frontiers in public health · 2025Article
- Article
- The impacts of diagnosis-intervention packet payment on the providers' behavior of inpatient care-evidence from a national pilot city in China.Frontiers in public health · 2023Article
- Association between service scope of primary care facilities and patient outcomes: a retrospective study in rural Guizhou, China.BMC health services research · 2021Article
- Factors associated with child delivery expenditure during the transition to the national implementation of the two-child policy in China.Health and quality of life outcomes · 2021Article
- Impact of maternal nationality on caesarean section rate variation in a high-income country.Qatar medical journal · 2021Article
- Determinants of length of stay after cesarean sections in the Friuli Venezia Giulia Region (North-Eastern Italy), 2005-2015.Scientific reports · 2020Article
- Association between direct government subsidies and service scope of primary care facilities: a cross-sectional study in China.International journal for equity in health · 2020Article
- 'Hybrid' top down bottom up health system innovation in rural China: A qualitative analysis.PloS one · 2020Article
- A Systematic Evaluation of Hospital Performance of Childbirth Delivery Modes and Associated Factors in the Friuli Venezia Giulia Region (North-Eastern Italy), 2005-2015.Scientific reports · 2019Article
- The effect of the health poverty alleviation project on financial risk protection for rural residents: evidence from Chishui City, China.International journal for equity in health · 2019Article
- Cesarean delivery rates, costs and readmission of childbirth in the new cooperative medical scheme after implementation of an episode-based bundled payment (EBP) policy.BMC public health · 2019Article
- Article
- Medical Service Quality, Efficiency and Cost Control Effectiveness of Upgraded Case Payment in Rural China: A Retrospective Study.International journal of environmental research and public health · 2018Article
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Abstract
backgroundIn China, increases in both the caesarean section (CS) rates and delivery costs have raised questions regarding the reform of the medical insurance payment system. Case payment is useful for regulating the behaviour of health providers and for controlling the CS rates and excessive increases in medical expenses. New Cooperative Medical Scheme (NCMS) agencies in Xi County in Henan Province piloted a case payment reform (CPR) in delivery for inpatients. We aimed to observe the changes in the CS rates, compare the changes in delivery-related variables, and identify variables related to delivery costs before and after the CPR in Xi County.
methodsOverall, 28,314 cases were selected from the Xi County NCMS agency from 2009 to 2010 and from 2014 to 2015. One-way ANOVA and chi-square tests were used to compare the distributions of CS and vaginal delivery (VD) before and after the CPR under different indicators. We applied multivariate linear regressions for the total medical cost of the VD and CS groups and total samples to identify the relationships between medical expenses and variables.
resultsThe CS rates in Xi County increased from 26.1% to 32.5% after the CPR. The length of stay (LOS), total medical cost, and proportion of county hospitals increased in the CS and VD groups after the CPR, which had significant differences. The total medical cost in the CS and VD groups as well as the total samples was significantly influenced by inpatient age, LOS, and hospital type, and had a significant correlation with the CPR in the VD group and the total samples.
conclusionThe CPR might fail to control the growth of unreasonable medical expenses and regulate the behaviour of providers, which possibly resulted from the unreasonable compensation standard of case payments, prolonged LOS, and the increasing proportion of county hospitals. The NCMS should modify the case payment standard of delivery to inhibit providers' motivation to render CS services. The LOS should be controlled by implementing clinical guidelines, and a reference system should be established to guide patients in choosing reasonable hospitals.
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