Evidence for capitation reform in a New Rural Cooperative Medical Scheme in Pudong New Area, Shanghai: A longitudinal study.
Int J Health Plann Manage
; 32(3): 307-316, 2017 Jul.
Article
em En
| MEDLINE
| ID: mdl-28707707
ABSTRACT
Currently, China has been experiencing rapid growth of medical costs, serious waste of medical resources, increasing disease burden for residents, and a medical insurance fund deficit. Therefore, an urgent problem that needs to be solved is to choose a rational payment for the insurance system. To empirically evaluate the long-term effects of capitation reform in a New Rural Cooperative Medical Scheme in Pudong New Area, we collected and analysed data regarding financing, fund operation, medical service cost, and medical care-seeking behaviour from 2011 to 2015, a duration that includes data before and after reform. The data for financing and behaviours were compared year by year, and the monthly data for inpatient and outpatient costs were evaluated in a retrospective time series study. The capitation reform in Pudong New Area showed strong evidence of the power of medical cost control in the long run, while it was weak in reversing the number of patients flowing into secondary and tertiary hospitals. To make the payment of capitation play a bigger role in cost control in China, a tighter alignment of capitation with the general practitioner system and achieving dual referral is critical for future studies.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Capitação
/
Reforma dos Serviços de Saúde
/
Serviços de Saúde Rural
Tipo de estudo:
Observational_studies
Limite:
Humans
País/Região como assunto:
Asia
Idioma:
En
Revista:
Int J Health Plann Manage
Assunto da revista:
PESQUISA EM SERVICOS DE SAUDE
/
SERVICOS DE SAUDE
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
China