Amidst increasing concerns about healthcare costs and the management of depression, a new study published in the Journal of Affective Disorders has shed light on the impact that provider payment methods have on health expenditure for depressive patients in China. The study, conducted over a four-year period from 2013 to 2017, used a 5% random sample of urban claims data collected by the China Health Insurance Research Association, aiming to analyze healthcare costs stratified by service types and hospital levels.
Provider Payment Methods and Their Influence on Costs
The study, titled “How provider payment methods affect health expenditure of depressive patients? Empirical study from national claims data in China from 2013 to 2017,” explored the differences in health expenditure for patients with depression under various provider payment methods. These methods include fee-for-services, global budget, capitation, case-based, and per-diem payments. Under the lead authorship of Bai Qian from the State Key Laboratory of Quality Research in Chinese Medicine at the University of Macau, the research team fitted a generalized linear model to determine the associations between payment methods and expenditure.
The Data and Results
With a substantial sample size—64,615 depressive patient visits, comprised of 59,459 outpatients and 5,156 inpatients—the researchers uncovered significant distinctions in both total and out-of-pocket (OOP) expenditure across different provider payments. The findings highlight varying correlations between provider payment methods and healthcare costs, influenced by the types of service the patients received, and the level (primary, secondary, tertiary) of the hospitals in which they were treated.
Among outpatient services, capitation payment was correlated with substantial reductions in both total and OOP expenditure in primary institutes, while leading to increases in secondary hospitals. Global budget payment was associated with lower expenditure in secondary hospitals but had the opposite effect in tertiary hospitals when compared to fee-for-services. For inpatient services, the study found that both total and OOP expenditures were significantly lower under per-diem and case-based payments versus fee-for-services in primary and secondary hospitals. Interestingly, case-based payment was especially effective at reducing OOP expenses for inpatient services at tertiary hospitals.
Study Limitations and Implications
The authors, including Zhuang Hongyan from Beijing Anding Hospital and other Chinese institutions, acknowledged that the study was limited to urban claims data, indicating a need for further research into rural populations. They also cited a need for updated data to support future studies. However, the study’s findings provide empirical evidence that could guide optimization of mixed payment methods for treating depression in China, potentially reducing financial burdens on patients and healthcare systems alike.
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References
For those looking to delve deeper into the research, the following references provide essential context and background:
1. DOI of the study: 10.1016/j.jad.2024.01.100.
2. Bai, Q., Zhuang, H., Hu, H., et al. (2024). How provider payment methods affect health expenditure of depressive patients? Empirical study from national claims data in China from 2013 to 2017. Journal of Affective Disorders, 350, 286-294.
3. Zheng, P., Wang, Y., Chen, L., et al. (2016). The correlation between mental health and economic growth: A systematic review. Journal of Global Health, 6(1), 010402.
4. Ma, Y., Zhang, W., Fan, X., et al. (2017). The relationship between health insurance coverage and clinical outcomes among women with breast cancer in Beijing, China. BMC Cancer, 17(1), 454.
5. Yang, L., Sun, L., Wen, L., et al. (2016). Financing strategies to improve essential public health equalization and its effects in China. International Journal for Equity in Health, 15(1), 194.
Conclusion
In conclusion, the study conducted by Bai and colleagues and published in the Journal of Affective Disorders provided a valuable analysis of health expenditures for depressive patients under differing provider payment methods in China. By unveiling the varied impact on costs associated with different payment structures, the study offers crucial insights for policymakers seeking to optimize healthcare funding while ensuring quality care for depressive patients. The authors emphasize the need for ongoing research to fully understand these dynamics in broader and more diverse populations.
Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.
