Does capitation prepayment based Integrated County Healthcare Consortium affect inpatient distribution and benefits in Anhui Province, China? An interrupted time series analysis
Does capitation prepayment based Integrated County Healthcare Consortium affect inpatient distribution and benefits in Anhui Province, China? An interrupted time series analysis
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按人头预付的县医联体是否会影响中国安徽省的住院病人分布和福利？
DOI：
10.5334/ijic.4193
复制
发表时间：
2019-07
期刊：
影响因子：
--
通讯作者：
Jingjing Chang
中科院分区：
文献类型：
--
作者：
Dai Su;Yingchun Chen;Hongxia Gao;Haomiao Li;Liqun Shi;Jingjing Chang
目的：本研究旨在比较安徽省医疗卫生中心正式运行前后的住院人数、资金分配情况以及住院患者福利的水平和趋势变化。方法：研究期间，从2014年1月至2017年6月期间，从中国安徽省两个县的住院数据库中收集了总共1,013,815例住院病例。从2016年2月正式实施开始评估改革的效果。采用间断时间序列分析的分段线性回归对纵向时间序列数据进行分析。结果：平均住院费用呈下降趋势，实际补偿比例显着上升（p值<0.01）。两县大部分指标表现良好，其中阜南县的ICHC政策效果优于定远县。定远市改革后住院患者和新农合经费在县外的分布呈现上升趋势（0.27，95%CI：0.12～0.42，p值<0.01；0.70，95%CI：0.32～1.09，p值<0.01），改革后住院患者和新农合经费在乡镇的分布呈现更加明显的上升趋势福南（0.44，95%CI：0.22 至 0.67，p 值 < 0.001；0.34，95%CI：0.23 至 0.45，p 值 < 0.001）。结论：本研究表明，ICHC 政策为促进中国医疗保健服务体系的整合提供了有效的策略。这些策略包括加强家庭医生签约服务体系和健康管理、发展远程医疗技术、弥补医疗服务短板、引入私立医院组建新的医疗保健机构等。
Objective: This study aims to compare the level and trend changes of inpatient and funds distribution, as well as inpatient benefits before and after the official operation of the ICHC in Anhui. Methods: A total of 1,013,815 inpatient cases were collected from the hospitalisation database in two counties in Anhui Province, China, during the course of the study from January 2014 to June 2017. The effect of the reform was assessed beginning with its formal operation in February 2016. Longitudinal time series data were analysed using segmented linear regression of an interrupted time series analysis. Results: The average hospitalisation expenses showed a decreasing trend and the actual compensation ratio increased significantly (p-value < 0.01). Most of the indicators in the two counties performed well, and the effect of ICHC policy was better in Funan County than in Dingyuan County. The distribution of inpatients and NRCMS funds outside the county after the reform in Dingyuan showed an increasing trend (0.27, 95%CI: 0.12 to 0.42, p-value < 0.01; 0.70, 95%CI: 0.32 to 1.09, p-value < 0.01) and the distribution of inpatients and NRCMS funds in THs showed a more obvious upward trend after the reform in Funan (0.44, 95%CI: 0.22 to 0.67, p-value < 0.001; 0.34, 95%CI: 0.23 to 0.45, p-value < 0.001). Conclusions: This study suggests that the ICHC policy provides effective strategies in promoting the integration of the healthcare delivery system in China. These strategies include strengthening family doctor signing service system and health management, developing telemedicine technology, reducing the weak points of the healthcare services, and introducing private hospitals to form new ICHCs.
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DOI：
10.1136/bmj.d108
发表时间：
2011-01-25
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Serumaga B;Ross-Degnan D;Avery AJ;Elliott RA;Majumdar SR;Zhang F;Soumerai SB
通讯作者：
Soumerai SB
DOI：
10.1016/s0140-6736(14)62007-9
发表时间：
2015-03-28
期刊：
Lancet (London, England)
影响因子：
--
作者：
Dayer MJ;Jones S;Prendergast B;Baddour LM;Lockhart PB;Thornhill MH
通讯作者：
Thornhill MH
DOI：
10.1111/j.1468-0297.2011.02449.x
发表时间：
2011-08
期刊：
Economic journal (London, England)
影响因子：
--
作者：
Cooper Z;Gibbons S;Jones S;McGuire A
通讯作者：
McGuire A
中国新型农村合作医疗制度评价：从政策目标看成绩与不足
影响因子：
4.5
作者：
Li C;Hou Y;Sun M;Lu J;Wang Y;Li X;Chang F;Hao M
通讯作者：
Hao M
影响因子：
2.1
作者：
Brown, Philip H.;Theoharides, Caroline
通讯作者：
Theoharides, Caroline