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Effect of the new maternity insurance scheme on medical expenditures for caesarean delivery in Wuxi, China: a retrospective pre/post-reform case study |
Chun Chen1,2,Zhihong Cheng3,Ping Jiang3,Mei Sun2,Qi Zhang4(),Jun Lv2() |
1. School of Public Health and Management, Wenzhou Medical University, Wenzhou 325035, China 2. Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China 3. Affiliated Hospital, Jiangnan University, Wuxi 214062, China 4. School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA |
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Abstract 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.
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Keywords
maternity insurance scheme
financial incentive
caesarean delivery
medical expenditure
China
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Corresponding Author(s):
Qi Zhang,Jun Lv
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Just Accepted Date: 03 November 2016
Online First Date: 25 November 2016
Issue Date: 01 December 2016
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