Research on the influence of patient cost-sharing on medical expenses and health outcomes: Taking patients with heart failure as an example
ObjectiveThe objective of this study is to assess the impact of the changes in patient cost-sharing on the medical expenses and health outcomes of patients with heart failure in China.MethodsThe claim data of patients diagnosed with heart failure enrolled in the Urban Employees' Basic Medical I...
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| Format: | Article |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1121772/full |
| _version_ | 1797871265669709824 |
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| author | Huyang Zhang Huyang Zhang Huyang Zhang Huyang Zhang Ke Ning Jinxi Wang Hai Fang Hai Fang Hai Fang |
| author_facet | Huyang Zhang Huyang Zhang Huyang Zhang Huyang Zhang Ke Ning Jinxi Wang Hai Fang Hai Fang Hai Fang |
| author_sort | Huyang Zhang |
| collection | DOAJ |
| description | ObjectiveThe objective of this study is to assess the impact of the changes in patient cost-sharing on the medical expenses and health outcomes of patients with heart failure in China.MethodsThe claim data of patients diagnosed with heart failure enrolled in the Urban Employees' Basic Medical Insurance (UEBMI) in the Zhejiang province, China, was used, covering the period from 1 January 2013 to 31 December 2017. The impact of the policy change was estimated through the use of the difference-in-differences method and the event study method.ResultsA total of 6,766 patients and their electronic health insurance claim data were included in the baseline year of 2013. Following the change in the UEBMI reimbursement policies (policy change), a notable decrease was observed in the patient cost-sharing ratios, particularly in the copayment ratio within the policy. However, it did not result in a reduction of the out-of-pocket ratio, which remains a primary concern among patients. An increase was observed in annual outpatient medical expenses, while annual inpatient medical expenses decreased, leading to higher annual medical expenses in the treatment group in comparison to the control group. The effect of the UEBMI reimbursement policy change on health outcomes showed a reduction in the rehospitalization rate within 90 days; however, no significant impact was seen on the rehospitalization rate within 30 days.ConclusionThe impact of the policy change on medical expenses and health outcomes was found to be modest. To effectively address the financial burden on patients, it is crucial for policymakers to adopt a comprehensive approach that considers all aspects of medical insurance policies, including reimbursement policies. |
| first_indexed | 2024-04-10T00:41:10Z |
| format | Article |
| id | doaj.art-e07af4aad5fd4149a689cdb566d75786 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-10T00:41:10Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-e07af4aad5fd4149a689cdb566d757862023-03-14T05:55:01ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-03-011110.3389/fpubh.2023.11217721121772Research on the influence of patient cost-sharing on medical expenses and health outcomes: Taking patients with heart failure as an exampleHuyang Zhang0Huyang Zhang1Huyang Zhang2Huyang Zhang3Ke Ning4Jinxi Wang5Hai Fang6Hai Fang7Hai Fang8Department of Health Policy and Management, Peking University School of Public Health, Beijing, ChinaChina Center for Health Development Studies, Peking University, Beijing, ChinaInstitute for Global Health and Development, Peking University, Beijing, ChinaChina Center for Health Economic Research, Peking University, Beijing, ChinaSchool of Public Health, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaShanghai Songsheng Business Consulting Co. Ltd, Beijing, ChinaChina Center for Health Development Studies, Peking University, Beijing, ChinaInstitute for Global Health and Development, Peking University, Beijing, ChinaPeking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Peking University, Beijing, ChinaObjectiveThe objective of this study is to assess the impact of the changes in patient cost-sharing on the medical expenses and health outcomes of patients with heart failure in China.MethodsThe claim data of patients diagnosed with heart failure enrolled in the Urban Employees' Basic Medical Insurance (UEBMI) in the Zhejiang province, China, was used, covering the period from 1 January 2013 to 31 December 2017. The impact of the policy change was estimated through the use of the difference-in-differences method and the event study method.ResultsA total of 6,766 patients and their electronic health insurance claim data were included in the baseline year of 2013. Following the change in the UEBMI reimbursement policies (policy change), a notable decrease was observed in the patient cost-sharing ratios, particularly in the copayment ratio within the policy. However, it did not result in a reduction of the out-of-pocket ratio, which remains a primary concern among patients. An increase was observed in annual outpatient medical expenses, while annual inpatient medical expenses decreased, leading to higher annual medical expenses in the treatment group in comparison to the control group. The effect of the UEBMI reimbursement policy change on health outcomes showed a reduction in the rehospitalization rate within 90 days; however, no significant impact was seen on the rehospitalization rate within 30 days.ConclusionThe impact of the policy change on medical expenses and health outcomes was found to be modest. To effectively address the financial burden on patients, it is crucial for policymakers to adopt a comprehensive approach that considers all aspects of medical insurance policies, including reimbursement policies.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1121772/fullheart failurehealth insurance reimbursement policiesUrban Employees' Basic Medical Insurancemedical expenseshealth outcomescost-sharing ratios |
| spellingShingle | Huyang Zhang Huyang Zhang Huyang Zhang Huyang Zhang Ke Ning Jinxi Wang Hai Fang Hai Fang Hai Fang Research on the influence of patient cost-sharing on medical expenses and health outcomes: Taking patients with heart failure as an example Frontiers in Public Health heart failure health insurance reimbursement policies Urban Employees' Basic Medical Insurance medical expenses health outcomes cost-sharing ratios |
| title | Research on the influence of patient cost-sharing on medical expenses and health outcomes: Taking patients with heart failure as an example |
| title_full | Research on the influence of patient cost-sharing on medical expenses and health outcomes: Taking patients with heart failure as an example |
| title_fullStr | Research on the influence of patient cost-sharing on medical expenses and health outcomes: Taking patients with heart failure as an example |
| title_full_unstemmed | Research on the influence of patient cost-sharing on medical expenses and health outcomes: Taking patients with heart failure as an example |
| title_short | Research on the influence of patient cost-sharing on medical expenses and health outcomes: Taking patients with heart failure as an example |
| title_sort | research on the influence of patient cost sharing on medical expenses and health outcomes taking patients with heart failure as an example |
| topic | heart failure health insurance reimbursement policies Urban Employees' Basic Medical Insurance medical expenses health outcomes cost-sharing ratios |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1121772/full |
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