ArticleRisk management and healthcare policy2023
Impacts of Outpatient Payment Reforms on Volume and Expenditures in Public Hospitals: Evidence from a Quasi-Experimental Analysis in Zhejiang, China.
Article in Risk management and healthcare policy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
6 citing papers in PubMed, 7 citations in OpenAlex.
- Prospective payment system transformation (2000-2024): temporal trends, payment architecture, and cross-national variation.Health economics review · 2026Review
- Behavioral responses of healthcare providers to prospective payment systems: a systematic review using the WHO framework (2000-2024).Health economics review · 2026Review
- Does capitation payment influence healthcare service behavior in county medical community? Evidence from patients with diabetes in rural China.BMC public health · 2025Article
- Cost shifting or cost cutting by hospitals as a response to reimbursement reform? The case of diagnosis-related groups (DRG) scheme in China.Frontiers in public health · 2025Article
- Can single disease payment impact hospitalization expenses and quality in district hospital? A case study in Fujian, China.International journal for equity in health · 2024Article
- Impacts of DRG-Based Prepayment Reform on the Cost and Quality of Patients with Neurologic Disorders: Evidence from a Quasi-Experimental Analysis in Beijing, China.Risk management and healthcare policy · 2024Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: China developed an innovative episode-based payment scheme for outpatient care, namely "Ambulatory Patient Groups (APGs) + capitation" payment, to constrain inflation in outpatient expenditures. This study aimed to assess the effects of this payment method on volume and expenditures in Chinese public hospitals. Methods: A quasi-experimental study was conducted with 7 municipal and 12 county hospitals from Jinhua as the intervention group and 15 municipal and 24 county hospitals from three neighbouring cities as the control group. The payment reform was introduced to municipal and county hospitals in the intervention group in January 2020 and January 2021, respectively. Monthly data on volumes and outpatient expenditures were collected from each hospital from January 2019 to December 2021. Controlled interrupted time-series analyses were performed to determine the effects of the funding reforms. Results: Outpatient visits in municipal hospitals decreased by 1417.54 (p=0.048) per month on average compared with control ones after the reform was implemented, whilst that in county hospitals increased by 1058.04 (p=0.041) per month on average. The trend of drug expenditures ( Conclusion: The strength of the "AGPs + capitation" payment for outpatient care lies in its ability to control the excessive growth of medical expenses through correcting inappropriate incentives. However, minimising potential cost-shifting and risk-shifting to uninsured service items should be given attention.
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