ArticleBMJ open2019
Effects of expanding outpatient benefit package on the rationality of medical service utilisation of patients with hypertension: a quasi-experimental trial in rural China.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review of the impact of the National Medication Price Negotiated Policy on the accessibility of drugs in China, 2016-2024.BMJ open · 2024Pooled it
- A study of the impact of DIP payment reform on coronary heart disease hospitalization costs and equity.Frontiers in public health · 2025Article
- 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
- The impacts of the National Medication Price-Negotiated Policy on the financial burden of cancer patients in Shandong province, China: an interrupted time series analysis.BMC public health · 2022Article
- Association between service scope of primary care facilities and prevalence of high-cost population: a retrospective study in rural Guizhou, China.BMC primary care · 2022Article
- Factors affecting the healthcare utilization from Shasthyo Suroksha Karmasuchi scheme among the below-poverty-line population in one subdistrict in Bangladesh: a cross sectional study.BMC health services research · 2022Article
- Association between service scope of primary care facilities and patient outcomes: a retrospective study in rural Guizhou, China.BMC health services research · 2021Article
- 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
- Expanding Outpatient Benefit Package Without Increasing Total Spending: Evidence From Outpatient Benefit Reform for Non-Chronic Disease Patients.Inquiry : a journal of medical care organization, provision and financingArticle
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo estimate the effects of expanding outpatient benefit package on ameliorating the issues of over-reliance on inpatient services and seeking higher level medical services in rural China.
designA quasi-experimental design. SETTING AND
participants1673 pairs of patients with hypertension were selected after using propensity score matching from Dangyang county (intervention group) and Zhijiang (control group) county, Hubei province.
interventionThe outpatient annual reimbursement capping line was expanding from ¥300 to ¥600, daily capping line from ¥10/12 to ¥150. The compensation scope and institution were also enlarged from January 2016. OUTCOME MEASURES: The difference-in-differences model was used to estimate the effects on medical service type selection. χ
resultsThe intervention was associated with 3.225 times (p=0.001) increase in total visits. Outpatient visits increased by 3.3 times (p=0.008), whereas the township level presented a maximum increase of 1.932 times (p=0.001). The inpatient visits declined by 0.075 times (p=0.000), whereas county-level inpatient visits reached a maximum decrease of 0.042 times (p=0.033). Meanwhile, the township level exhibited a maximum proportion growth of 14.8% in outpatient (p=0.000) and 13.3% in inpatient visits (p=0.048). Outpatient visits at the county level dropped at 13.2% (p=0.000), whereas inpatients visits declined by 7.7% (p=0.040). The length of stay and blood pressure were decreased, respectively, compared with the control group.
conclusionImproving outpatient benefit package alleviated patient dependence on inpatient services through motivating outpatient service utilisation, consolidated the primacy of township health centres and guided patients to return to primary medical institutions. The health insurance reform should 'take the long view' in the future, and more attention should be paid to the rationality of medical service utilisation.
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