دورية أكاديمية
Can single disease payment impact hospitalization expenses and quality in district hospital? A case study in Fujian, China.
| العنوان: | Can single disease payment impact hospitalization expenses and quality in district hospital? A case study in Fujian, China. |
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| المؤلفون: | Zhang L; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen Fujian, 361102, PR China.; Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiamen Fujian, 361102, PR China., Sha W; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen Fujian, 361102, PR China.; Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiamen Fujian, 361102, PR China., Lin Q; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen Fujian, 361102, PR China.; Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiamen Fujian, 361102, PR China., Fang Y; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen Fujian, 361102, PR China. Fangya@xmu.edu.cn.; Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiamen Fujian, 361102, PR China. Fangya@xmu.edu.cn. |
| المصدر: | International journal for equity in health [Int J Equity Health] 2024 Mar 13; Vol. 23 (1), pp. 53. Date of Electronic Publication: 2024 Mar 13. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 101147692 Publication Model: Electronic Cited Medium: Internet ISSN: 1475-9276 (Electronic) Linking ISSN: 14759276 NLM ISO Abbreviation: Int J Equity Health Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [London] : BioMed Central, 2002- |
| مواضيع طبية MeSH: | Hospitals, District* , Diabetes Mellitus, Type 2*, Female ; Pregnancy ; Humans ; Hospitalization ; Cesarean Section ; Medically Uninsured ; China ; Health Expenditures |
| مستخلص: | Background: China is exploring payment reform methods for patients to address the escalating issue of increasing medical costs. While most district hospitals were still in the stage of Single Disease Payment (SDP) due to conditions, there is a scarcity of research on comprehensive assessment of SDP. This study aims to evaluate the implementation of SDP in a district hospital, and provided data support and scientific reference for improving SDP method and accelerating medical insurance payment reform at district hospitals. Methods: Data was collected from 2337 inpatient medical records at a district hospital in Fuzhou, China from 2016 to 2021. These diagnoses principally included type 2 diabetes, planned cesarean sections, and lacunar infarction. Structural variation analysis was conducted to examine changes in the internal cost structure and dynamic shifts in medical expenses for both the insured (treatment group) and uninsured (control group) patients, pre- and post-implementation of the SDP policy on August 1, 2018. The difference-in-differences (DID) method was employed to assess changes in hospitalization expenses and quality indicators pre- and post-implementation. Furthermore, subjective evaluation of medical quality was enhanced through questionnaire surveys with 181 patients and 138 medical staff members. Results: The implementation of SDP decreased the medical expenses decreased significantly (P < 0.05), which can also optimize the cost structure. The drug cost ratio descended significantly, and the proportion of laboratory fee rose slightly. The changes in infection rate, cure rate, and length of stay indicated enhanced medical quality (P < 0.05). The satisfaction of inpatients with SDP was high (89.2%). Medical staff expressed an upper middle level of satisfaction (77.2%) but identified difficulties with the implementation such as "insufficient coverage of disease types". Conclusion: After the implementation of SDP in district hospitals, considerable progress has been achieved in restraining medical expenses, coupled with notable enhancements in both medical quality and patient satisfaction levels. However, challenges persist regarding cost structure optimization and underutilization of medical resources. This study suggests that district hospitals can expedite insurance payment reform by optimizing drug procurement policies, sharing examination information, and strengthening the management of medical records. (© 2024. The Author(s).) |
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| معلومات مُعتمدة: | 81973144 National Natural Science Foundation of China; 81973144 National Natural Science Foundation of China; 81973144 National Natural Science Foundation of China; 81973144 National Natural Science Foundation of China; FJ2022C047 Fujian Province Social Science Foundation Project; FJ2022C047 Fujian Province Social Science Foundation Project; FJ2022C047 Fujian Province Social Science Foundation Project; FJ2022C047 Fujian Province Social Science Foundation Project; [2022]C1701 General Project of Xiamen Social Science Research Project in 2022; [2022]C1701 General Project of Xiamen Social Science Research Project in 2022; [2022]C1701 General Project of Xiamen Social Science Research Project in 2022; [2022]C1701 General Project of Xiamen Social Science Research Project in 2022 |
| فهرسة مساهمة: | Keywords: China; District hospitals; Effect evaluation; Medical expenses; Single disease payment |
| تواريخ الأحداث: | Date Created: 20240314 Date Completed: 20240315 Latest Revision: 20240316 |
| رمز التحديث: | 20240316 |
| مُعرف محوري في PubMed: | PMC10938684 |
| DOI: | 10.1186/s12939-024-02134-2 |
| PMID: | 38481259 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1475-9276 |
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| DOI: | 10.1186/s12939-024-02134-2 |