The effects of patient cost sharing on inpatient utilization, cost, and outcome

PloS One
Yuan XuHude Quan

Abstract

Health insurance and provider payment reforms all over the world beg a key empirical question: what are the potential impacts of patient cost-sharing on health care utilization, cost and outcomes? The unique health insurance system and rich electronic medical record (EMR) data in China provides us a unique opportunity to study this topic. Four years (2010 to 2014) of EMR data from one medical center in China were utilized, including 10,858 adult patients with liver diseases. We measured patient cost-sharing using actual reimbursement ratio (RR) which is allowed us to better capture financial incentive than using type of health insurance. A rigorous risk adjustment method was employed with both comorbidities and disease severity measures acting as risk adjustors. Associations between RR and health use, costs and outcome were analyzed by multivariate analyses. After risk adjustment, patients with more generous health insurance coverage (higher RR) were found to have longer hospital stay, higher total cost, higher medication cost, and higher ratio of medication to total cost, as well as higher number and likelihood that specific procedures were performed. Our study implied that patient cost-sharing affects health care services use...Continue Reading

References

Jul 1, 2008·Journal of Health Economics·Rose Anne Devlin, Sisira Sarma
Apr 20, 2010·International Journal of Medical Informatics·Danhong LiuKeqin Rao
Oct 14, 2011·The New England Journal of Medicine·Paul B Ginsburg
Jan 31, 2012·Journal of Hepatology·Fabio FarinatiFranco Trevisani
Mar 6, 2012·Lancet·Winnie Chi-Man YipAlan Maynard
Aug 13, 2013·Journal of the American Medical Informatics Association : JAMIA·Yan XuEric I Chang
Apr 15, 2014·Journal of Hepatology·Sasan Roayaie
Sep 25, 2015·Journal of Epidemiology·He HuangYou-Lin Qiao
Dec 3, 2015·BMJ Open Gastroenterology·Xiao-Yuan BaoGuo-Pei Yu
Aug 21, 2016·BMC Medical Informatics and Decision Making·Yuan XuHude Quan

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