DIP Reform's Effect on Cost Control and Cost-Shifting for Inpatient Coronary Heart Disease Patients
- VernacularTitle:DIP支付方式改革对冠心病住院患者的费用控制效应和费用转移效应研究
- Author:
Xinye PENG
1
;
Huawei TAN
;
Xueyu ZHANG
Author Information
1. 武汉大学中南医院 湖北 武汉 430071
- Keywords:
payment reform;
Diagnosis-Intervention Packet;
coronary heart disease;
cost control;
cost-shifting
- From:
Chinese Health Economics
2024;43(11):27-31
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the cost control effect and cost-shifting effect of Diagnosis-Intervention Packet(DIP)payment reform on inpatient coronary heart disease patients.Methods:Z City,a national pilot city for DIP,is taken as a case study.It utilizes inpatient claims data and the propensity scoring matching-difference in differences method to evaluate the impact of DIP payment reform on total medical expenses,Out-of-Pocket(OOP),the OOP proportion,self-paid Category B expenses,the proportion of self-paid Category B expenses,Category C expenses,and the proportion of Category C expenses for coronary heart disease inpatients.Results:After the DIP reform,the total medical expenses per inpatient coronary heart disease patient significantly decreased(β=-0.127,P＜0.01).Regarding cost-shifting,the OOP expenses(β=0.108,P＜0.05),the OOP proportion(β=0.055,P＜0.01),self-paid Category B expenses(β=0.239,P＜0.01),the proportion of self-paid Category B expenses(β=0.030,P＜0.01),and the proportion of Category C expenses significantly increased(β=0.026,P＜0.01),while there was no significant change in Category C expenses.Conclusion:The DIP reform significantly reduced the total medical expenses per inpatient case of coronary heart disease.At the same time,the reform shifted costs from within the scope of the insurance policy to outside the policy's coverage,with a stronger shift observed from Category B to Category C expenses.
