ArticleInternational journal of health policy and management2022
Managing Urban Stroke Health Expenditures in China: Role of Payment Method and Hospital Level.
Article in International journal of health policy and management, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness and safety of Angong Niuhuang pill in treatment of acute stroke: a systematic review and Meta-analysis.Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2023Pooled it
- Risk-adjusted capitation payment for outpatient services in China's healthcare insurance: a case study of an affluent city in southern China.Frontiers in public health · 2026Article
- The impact of the global budget payment on healthcare fund expenditure in integrated delivery systems: evidence from China's county-level medical alliance reform.Frontiers in public health · 2026Article
- Does a new case-based payment system promote the construction of the ordered health delivery system? Evidence from a pilot city in China.International journal for equity in health · 2024Article
- The Economic Burden of Brucellosis Care in China: Socioeconomic Status Inequality.Journal of tropical medicine · 2024Article
- Hospitalization costs in patients with stroke in southeastern China: a retrospective population-based cohort study, 2019-2022.Frontiers in public health · 2024Article
- Medical insurance payment schemes and patient medical expenses: a cross-sectional study of lung cancer patients in urban China.BMC health services research · 2023Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStroke is one of the leading public health issues in China and imposes a heavy financial burden on patients and the healthcare system. This study assess which payment method provides the lowest hospital costs for China's healthcare system and the lowest out-of-pocket (OOP) expense for insured patients.
methodsThis is a 4-year cross-sectional study. From the China Health Insurance Research Association (CHIRA) database, a 5% random sample of urban health insurance claims was obtained. Descriptive analysis was conducted and a generalized linear model (GLM) with a gamma distribution and a log link was estimated.
resultsFor outpatients, capitation payment had the lowest hospital cost (RMB180.9/US$28.8) and lowest OOP expenses (RMB75.6/US$12.0) per patient visit in primary hospitals compared with fee-for-service (FFS) payments. The global budget (GB) displayed the lowest total hospital costs (RMB344.7/US$54.8) in secondary hospitals, and was 27.4% (95% CI=-0.32, -0.29) lower than FFS. FFS had the lowest OOP expenses (RMB123.4/US$19.6 vs. RMB151.8/US$24.1) in secondary and tertiary hospitals. For inpatients, FFS had the lowest total hospital costs (RMB5918.7/US$941.1) per visit and capitation payments had the lowest OOP expenses (RMB876.5/US$139.4, 40.1% lower than FFS, 95% CI=-0.58, -0.15) in primary hospitals. Capitation payment had both the lowest hospital costs (RMB7342.9/US$1167.5 vs. RMB17 711.7/US$2816.2) and the lowest OOP expenses (RMB1664.2/US$264.6 vs. RMB3276.3/US$520.9) for both secondary and tertiary hospitals.
conclusionFor outpatients in primary hospitals and inpatients in secondary and tertiary hospitals, the capitation payment was the most money-saving payment method delivering both the lowest OOP expenses for patients and the lowest hospital total costs for hospitals. We recommend that health policymakers prioritize the implementation of the payment method with the lowest OOP expenses when the payment method does not deliver both the lowest hospital costs for the health system and lowest OOP expenses for patients.
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