Absence of appropriate hospitalization cost control for patients with medical insurance: a comparative analysis study

Pan, Xian-Ming; Dib, Hassan; Zhu, Manlu; Zhang, Ying; Yang, Fan

doi:10.1002/hec.1421

Cited by 13 publications

(9 citation statements)

References 31 publications

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“…Studies on OOP spending for inpatient treatment show that insurance encourages individuals to go to higher-level care, with an approximate 3% rise in higher-level visitsmeaning people go to a county-level health care center rather than a township-level health care center, which is more centralized in the government hierarchy-and stay longer, with a marginal increase of 1.37 days for Rural Resident Insurance enrollees (2), raising the overall cost of care for insured persons (55). These contrasting forces, the increased insurance coverage but more expensive care at higher-level health care centers and greater utilization such as longer stays, drive much of the variation in research study results, depending on if the study measures burden sharing or total OOP expenses (26,40,71), and highlight the need for both cost control mechanisms and careful economic evaluations of the impact of reforms.…”

Section: Impact Of Insurance On Patientsmentioning

confidence: 99%

China's Health Reform Update

Liu

Vortherms

Hong

2017

Annu. Rev. Public Health

214

215

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China experienced both economic and epistemological transitions within the past few decades, greatly increasing demand for accessible and affordable health care. These shifts put significant pressure on the existing outdated, highly centralized bureaucratic system. Adjusting to growing demands, the government has pursued a new round of health reforms since the late 2000s; the main goals are to reform health care financing, essential drug policies, and public hospitals. Health care financing reform led to universal basic medical insurance, whereas the public hospital reform required more complex measures ranging from changes in regulatory, operational, and service delivery settings to personnel management. This article reviews these major policy changes and the literature-based evidence of the effects of reforms on cost, access, and quality of care. It then highlights the outlook for future reforms. We argue that a better understanding of the unintended consequences of reform policies and of how practitioners' and patients' interests can be better aligned is essential for reforms to succeed.

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Section: Impact Of Insurance On Patientsmentioning

confidence: 99%

China's Health Reform Update

Liu

Vortherms

Hong

2017

Annu. Rev. Public Health

214

215

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“…Three recent studies shed light on (iii). Pan et al (2008) examine the effect of insurance on the hospital costs of 10 medium-size urban hospitals in Guangdong province, focusing on four conditions where there is a high degree of consensus over diagnosis and treatment. They found that spending on insured patients was around 10% higher than that on uninsured patients.…”

Section: Insurance and Its Impactsmentioning

confidence: 99%

“…Liu et al, 1996) were arguing for a subsidized voluntary community health insurance scheme to replace the largely defunct CMS. The designs of the programs proposed were quite modest compared with the NRCMS that emerged in 2003. directive came into effect in 2003, permitting BMI members to claim reimbursement for expenses incurred at community health centers (Pan et al, 2008). At the time, however, community health centers were notorious for their poor service, and hence in 2005 the government announced its intention to create a network of new centers to provide high-quality preventive, primary and home care and rehabilitative services (Yip and Hsiao, 2008).…”

Section: China's Health Reforms Since 2002mentioning

confidence: 99%

China's health system and its reform: a review of recent studies

et al. 2009

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This paper provides a survey of the recent empirical research on China's 'old' health system (i.e. prior to the spate of reforms beginning in 2003). It argues that this research has enhanced our understanding of the system prior to 2003, in some cases reinforcing conclusions (e.g. the demand-inducement associated with perverse incentives) while in other cases suggesting a slightly less clear storyline (e.g. the link between insurance and out-of-pocket spending). It also concludes that the research to date points to the importance of careful evaluation of the current reforms, and its potential to modify policies as the rollout proceeds. Finally, it argues that the research on the pre-2003 system suggests that while the recently announced further reforms are a step in the right direction, the hoped-for improvements in China's health system will far more likely occur if the reforms become less timid in certain key areas, namely provider payments and intergovernmental fiscal relations.

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“…Given that inpatient reimbursement rates are between 42% and 65% of inpatient costs, hospitalization continues to place a major financial burden on families. Moreover, studies have documented higher charges for insured patients (Pan et al , ).…”

Section: Discussionmentioning

confidence: 99%

Development and status of health insurance systems in China

Barber¹,

Yao

2011

Int J Health Plann Mgmt

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Health insurance programs have changed rapidly over time in China. Among rural populations, insurance coverage shifted from nearly universal levels in the 1970s to 7% in 1999; it stands at 94% of counties in 2009. This large increase is the result of a series of health reforms that aim to achieve universal access to healthcare and better risk protection, largely through the rollout of the health insurance programs and the gradual increase in subsidies and benefits over time. In this paper, we present the development of the rural and urban health insurance programs, their modes of financing and operation and the benefits and reimbursement schemes at the end of 2009. We discuss some of the problems with the rural and urban residents' schemes including reliance on local government capacity, reimbursement ceilings and rates, and incentives for unnecessary care and waste in the design of the programs. Recommendations include increasing financial support and deepening the benefits packages. Strategies to control cost and improve quality include developing mixed provider payment mechanisms, implementing essential medicines policies and strengthening the quality of primary-care provision.

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Absence of appropriate hospitalization cost control for patients with medical insurance: a comparative analysis study

Abstract: Require a better government's supervision system over medical insurance expenses such as reforming methods of payments, building up new cost compensation mechanism, and unifying and stabilizing prices for each category of medicines.

Cited by 13 publications

References 31 publications

China's Health Reform Update

China's Health Reform Update

China's health system and its reform: a review of recent studies

Development and status of health insurance systems in China

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