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RSS FeedsIJERPH, Vol. 20, Pages 2522: Cost Sharing and Cost Shifting Mechanisms under a per Diem Payment System in a County of China (International Journal of Environmental Research and Public Health)

 
 

31 january 2023 10:31:19

 
IJERPH, Vol. 20, Pages 2522: Cost Sharing and Cost Shifting Mechanisms under a per Diem Payment System in a County of China (International Journal of Environmental Research and Public Health)
 


Cost sharing and cost shifting mechanisms are of vital importance in a prospective payment system. This paper employed the difference-in-differences method to estimate the impacts of a per diem system with inverted-U-shape rates on medical costs and the length of stay based on data from a health insurance institution. The supply side cost sharing mechanism worked so that the new payment system significantly reduced medical costs by 17.59 percent while the average length of stay varied little. After further analyzing the mechanism, we found that heterogeneous effects emerged mainly due to the special rates design. The reform decreased the cases that incurred relatively high medical costs and lengths of stay. However, cost shifting existed so that physicians could be motivated to provide unnecessary services to the patients who should have been discharged before the average length of stay. Therefore, payment rates in the per diem system require a sophisticated design to constrain its distortion to medical service provision even though medical expenditures were successfully contained.


 
70 viewsCategory: Medicine, Pathology, Toxicology
 
IJERPH, Vol. 20, Pages 2523: Molecular Transmission Network of Newly Reported HIV Infections in Pengzhou, Sichuan Province: A Study Based on Genomics and Spatial Epidemiology (International Journal of Environmental Research and Public Health)
IJERPH, Vol. 20, Pages 2525: Preventive Behaviors and Influencing Factors among Thai Residents in Endemic Areas during the Highest Epidemic Peak of the COVID-19 Outbreak (International Journal of Environmental Research and Public Health)
 
 
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