Research on the Application of Interrupted Time-series Analysis in the Effect Evaluation of the Payment Reform of Basic Medical Insurance
Objective The aim of this study is to evaluate the effect of the payment reform of basic medical insurance on cost,medical behavior and patients′ burden.So as to provide a reference for improving the payment reform in Changsha.Methods Interrupted time-series method was used to analyze the changes of the same-day readmission rate,average hospitalization cost per time and the out-of-pocket proportion before and after the payment reform.Stakeholder interviews were used to investigate suggestions and possible reasons for the change.Results The average hospitalization cost per time and the out-of-pocket proportion of insured patients decreased significantly in early stage of the reform,and then showed an increasing trend.The growth rate of the total number of inpatients and the decrease of same-day readmission rate declined.The results of interrupted time-series analysis showed that the growth rate of total inpatients decreased from 600 per month to 20 per month after the payment reform.The same-day readmission rate increased by 0.237%in the short term after the reform,but showed a downward trend in the long term,with the rate decreasing from 0.014%per month before the reform to 0.003%per month.In the short term after the reform,the average hospitalization cost per time fell by 786.360,and the proportion of out-of-pocket decreased by 2.089%.Conclusion The effects of controlling cost and alleviating patients′ burden were obvious in the initial reform of the basic medical insurance for urban employees in Changsha,but the long-term supervision needs to be strengthened,especially for decomposition of hospitalization and patients′burden relief.
The payment reform of medical insurancePolicy assessmentInterrupted time-series analysis
NETL
NSTL
万方数据
