Impact of the Global Budget Payment System on Expenditure of Cardiovascular Diseases: An Interrupted Time Series Analysis in Shanghai, China

Guanshen Dou, Yilin Zhang, Yunzhen He, Qiaoyun Huang, Yingfeng Ye, Xinyu Zhang, Weibing Wang and Xiaohua Ying
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Guanshen Dou: NHC Key Laboratory of Health Technology Assessment (Fudan University), Department of Health Economics, School of Public Health, Fudan University, Shanghai 200032, China
Yilin Zhang: London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK
Yunzhen He: NHC Key Laboratory of Health Technology Assessment (Fudan University), Department of Health Economics, School of Public Health, Fudan University, Shanghai 200032, China
Qiaoyun Huang: School of Public Health, Kunming Medical University, Kunming 650500, China
Yingfeng Ye: NHC Key Laboratory of Health Technology Assessment (Fudan University), Department of Health Economics, School of Public Health, Fudan University, Shanghai 200032, China
Xinyu Zhang: NHC Key Laboratory of Health Technology Assessment (Fudan University), Department of Health Economics, School of Public Health, Fudan University, Shanghai 200032, China
Weibing Wang: Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
Xiaohua Ying: NHC Key Laboratory of Health Technology Assessment (Fudan University), Department of Health Economics, School of Public Health, Fudan University, Shanghai 200032, China

IJERPH, 2019, vol. 16, issue 8, 1-14

Abstract: Since few studies evaluated the impact of the global budget payment system (GBPS) over time, and by expenditure type, this paper aims to evaluate the impact of the GBPS on expenditure of inpatients, and explores how hospitals curb the expenditure in patients with cardiovascular diseases (CVDs) in Shanghai. We built a time series model with the monthly expenditure of CVDs from 2009 to 2012. We evaluated the instant impact and trends impact of the GBPS and analyzed results based on medical expenditure types (e.g., drug, examination, cure, unclassified items), discharge number, and expenditure per capita. We found GBPS instantly dropped the medical expenditure by Chinese Yuan (CNY) 55.71 million ( p < 0.001), and decreased the monthly increasing trend by CNY 4.23 million ( p = 0.011). The discharge number had 10.4% instant reduction and 225.55 monthly decrease ( p = 0.021) while the expenditure per capita experienced fewer changes. Moreover, the expenditure of drug and cure had an instant reduction of CNY 28.31 million and 16.28 million ( p < 0.001). In conclusion, we considered the GBPS is an effective solution to control the expenditure of CVDs by decreasing the discharge number, and a focus on the drug and cure expenditures lead to greater spend reduction than other types of expenditures.

Keywords: global budget payment system; cardiovascular diseases; medical expenditure; China (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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