ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2022
Effects of establishing a financing scheme for outpatient care on inpatient services: empirical evidence from a quasi-experiment in China.
Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- An unintended complementarity: how the outpatient pooling policy increases inpatient services in China.Health policy and planning · 2026Article
- Does chronic disease coverage for outpatient care affect healthcare utilization and expenditures in China? Evidence from an administrative claim dataset.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Health Shocks and Debt Risk Among Middle-Aged and Elderly Individuals in China: The Mediating Roles of Informal Self-Treatment and Formal Healthcare Utilization.Risk management and healthcare policy · 2026Article
- Dynamic effects of outpatient pooling scheme on socioeconomic inequality in healthcare utilization in China from 2011 to 2020.Scientific reports · 2025Article
- Enhancing health system efficiency in China: considering the interaction between use of primary care and the demand for secondary and tertiary care.Health policy and planning · 2025Article
- Medical insurance integration and rural-urban benefit disparities, 2006-2021: evidence from quasi-natural experiments in China.BMJ open · 2025Article
- Medical insurance integration and spatial effects in China: evidence from quasi-natural experiments and linked administrative data.BMC health services research · 2025Article
- A Chinese conundrum: does higher insurance coverage for hospitalization reduce financial protection for the patients who most need it?Health policy and planning · 2025Article
- Will the increase of medical equipment affect medical expenditure? Empirical evidence from a quasi-experiment in China.BMC health services research · 2025Article
- Impact of Enhanced Outpatient Pooling Level on Healthcare Utilization, Costs and Fund Expenditures in China: An Interrupted Time Series Analysis.Risk management and healthcare policy · 2025Article
- Impact of Insurance on Readmission Rates, Healthcare Expenditures, and Length of Hospital Stay among Patients with Chronic Ambulatory Care Sensitive Conditions in China.Healthcare (Basel, Switzerland) · 2024Article
- Temporal-spatial distribution characteristics and associated socioeconomic factors of visiting frequency for rural patients with hypertension in Fujian Province, Southeast China.BMC public health · 2024Article
- Inequality in benefit distribution of reducing the outpatient cost-sharing: evidence from the outpatient pooling scheme in China.Frontiers in public health · 2024Article
- Does the immediate reimbursement of medical insurance reduce the socioeconomic inequality in health among the floating population? Evidence from China.International journal for equity in health · 2023Article
- Effects of decreasing the out-of-pocket expenses for outpatient care on health-seeking behaviors, health outcomes and medical expenses of people with diabetes: evidence from China.International journal for equity in health · 2022Article
- 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
1 author.
Funding
Abstract
The relationship between outpatient and inpatient care is central to the current healthcare reform debate especially in developing countries. Despite the importance of this relationship to health policy makers, empirical evidence, particularly evidence that can be interpreted as causal is limited and inconclusive. This paper examines the effects of establishing a financing scheme for outpatient care on inpatient utilization and expenditure in China's Urban Employee Basic Medical Insurance scheme. Under a quasi-experimental design, we use a unique administrative insurance claim dataset and conduct a difference-in-differences analysis. Our results indicate that after the policy change, total number of admissions and total inpatient expenditure of the enrollees decreased by 0.47% and 6.05% respectively, which imply outpatient and inpatient care are substitutes, and the reduction in cost-sharing can release the underuse of the outpatient care, so as to reduce those excessive demands for inpatient care. Moreover, we present evidence that the effects on the admissions of Ambulatory Care Sensitive Conditions which should be sensitive to outpatient care intervention are relatively limited because of the lower reimbursement cap, inadequate capacity of the local primary care providers and stickiness in patients' healthcare-seeking behaviors. While the enrollees aged over 55 and retirees are more vulnerable to the medical prices, and the enrollees living in the central districts are more responsive because of the better and more accessible primary care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.