Expanding outpatient benefits package can reduce diabetes-related avoidable hospitalizations

Abstract

ObjectiveTo evaluate the policy effect of replacing hospitalization service with outpatient service and reducing diabetes-related avoidable hospitalizations by improving outpatient benefits package.MethodsA database of hospital discharge from 2015 to 2017 in City Z was used. All diabetic inpatient cases enrolled in Urban Employee Basic Medical Insurance were selected as the intervention group, and diabetic inpatient cases enrolled in Urban and Rural Resident Basic Medical Insurance were selected as the control group. The Difference-in-Difference model was used to analyze the effect of improving outpatient benefits package level of diabetes from 1800 yuan (about $252.82) to 2400 yuan (about $337.09) per capita per year on avoidable hospitalization rate, average hospitalization cost and average length of stay.ResultsThe avoidable hospitalization rate of diabetes mellitus decreased by 0.21 percentage points (P < 0.01), the average total cost of hospitalization increased by 7.89% (P < 0.01), and the average length of stay per hospitalization increased by 5.63% (P < 0.01).ConclusionsImproving the outpatient benefits package of diabetes can play a role in replacing hospitalization service with outpatient service, reducing diabetes-related avoidable hospitalizations, and reducing the disease burden and financial burden.

Does introducing outpatient pooling scheme reduce socioeconomic inequality in healthcare utilization? Evidence from a longitudinal study in China, 2011–2020

“…In contrast to inpatient services, outpatient care exhibits a heightened frequency of utilization and holds the capacity to address a majority of healthcare needs, particularly for individuals contending with chronic diseases and the elderly [8,9]. Timely access to outpatient care stands as a pivotal factor in mitigating delays in disease treatment, thereby optimizing the effectiveness of early prevention and intervention strategies [10][11][12]. Evidently, the presence of financial impediments to outpatient care for disadvantaged populations presents a formidable challenge in ensuring healthcare equity.…”

The Performance of Primary Healthcare in China: The Need for a Systematic Design for Improvement Comment on "Quality and Performance Measurement in Primary Diabetes Care: A Qualitative Study in Urban China"

“…Taking outpatient services as an example, the proportion of outpatient appointments rose from 39.9% in 2009 to 60.3% in 2021. 4 At the same time, high and avoidable hospitalization rates of Chinese residents, including the patients with diabetes that Rasooly and colleagues are primarily concerned with, have shown little sign of declining in recent years, 5 , 6 providing further evidence of poor PHC provision.…”