Effect of the new maternity insurance scheme on medical expenditures for caesarean delivery in Wuxi, China: a retrospective pre/post-reform case study

详细信息    查看全文

• 作者：Chun Chen ; Zhihong Cheng ; Ping Jiang ; Mei Sun ; Qi Zhang ; Jun Lv
• 关键词：maternity insurance scheme ; financial incentive ; caesarean delivery ; medical expenditure ; China
• 刊名：Frontiers of Medicine
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：10
• 期：4
• 页码：473-480
• 全文大小：
• 刊物主题：Medicine/Public Health, general;
• 出版者：Higher Education Press
• ISSN：2095-0225
• 卷排序：10

文摘

Aiming to control rising medical expenditures and help improve China’s healthcare systems, this study examined whether a cap-based medical insurance scheme with shared financial interest between the insurance and healthcare providers is effective in containing hospitals’ C-section medical expenditures. We used 6547 caesarean delivery case records from a teaching tertiary-level general public hospital located in Wuxi, China (2004–2013), and used the Chow test to investigate the possibility of significant variation in mean medical expenditures for caesarean deliveries pre- and post-reform. We also used paired sample t-tests and linear regression models to compare the mean medical expenditures between insured and uninsured women undergoing caesarean delivery during the post-reform period. After the scheme’s implementation, medical expenditures for caesarean deliveries declined and the medical expenditures of women covered by the scheme were significantly lower than those of uninsured patients. These findings indicated the scheme’s effectiveness in minimizing caesarean delivery expenditures. The cap-based medical insurance scheme with shared financial interest between insurance and healthcare providers would likely steer healthcare providers’ behaviors in a more cost-effective direction.