ArticleBMJ open2019
Impact of capitation on outpatient expenses among patients with diabetes mellitus in Tianjin, China: a natural experiment.
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 5 papers.
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Who cites it
5 citing papers in PubMed.
- A study of the impact of DIP payment reform on coronary heart disease hospitalization costs and equity.Frontiers in public health · 2025Article
- Impact of capitation on physicians' behavior among patients with hypertension: an interrupted time series study in rural China.BMC public health · 2024Article
- Impact of capitation prepayment on the medical expenses and health service utilization of patients with coronary heart disease: a community policy intervention program in a county in China.BMC public health · 2023Article
- 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
- Epidemiology of undiagnosed type 2 diabetes mellitus among hill tribe adults in Thailand.Scientific reports · 2022Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesCapitation policy, a new medical insurance settlement method implemented on 1 January 2014 in Tianjin, China, aimed to control unreasonable increases in medical costs. The goal of the current study was to evaluate the impact of capitation on outpatient expenses among patients with diabetes mellitus and provide scientific evidence for health policy-makers.
designA natural experiment.
settingThe medical insurance database of Tianjin from 1 January 2010 to 31 December 2014.
participantsIn total, 35 529 records were included, comprising 9646 records in the pilot group (4907 records in 2014 and 4739 records in 2013) and 25 883 records in the control group (9814 records in 2014 and 16 069 records in 2013).
main outcome measuresThe outcome variables included annual total outpatient expenses, drug expenses, examination expenses, treatment expenses and other expenses.
resultsCapitation produced an increase in total outpatient expenses of ¥1993.76 (95% CI, ¥1643.74 to ¥2343.77) in the pilot group relative to the control group. There was also an increase in drug expenses of ¥1904.30 (95% CI, ¥1578.63 to ¥2229.96) after the implementation of capitation. An increase in examination expenses of ¥44.90 (95% CI, ¥19.11 to ¥70.68) was found in the pilot group versus the control group. Capitation also produced an increase in treatment expenses of ¥3.55 (95% CI, ¥1.01 to ¥6.09) and an increase in other expenses of ¥43.46 (95% CI, ¥26.81 to ¥60.11) in the pilot group versus the control group.
conclusionCompared with those who participated in the 'control' policy, outpatient expenses of patients enrolled in capitation increased significantly. The increases were due to the actual needs of patients, changes in drug directories, and the autonomy and independence of hospitals. It is necessary for the government, policy-makers, hospitals, doctors, patients and supervisory agencies to improve the capitation policy.
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