Effect of an Integrated Payment System on the Direct Economic Burden and Readmission of Rural Cerebral Infarction Inpatients: Evidence from Anhui, China

Rural China is piloting an integrated payment system, which prepays a budget to a medical alliance rather than a single hospital. This study aims to evaluate the effect of this reform on the direct economic burden and readmission rates of cerebral infarction inpatients. The settlement records of 78,...
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Autor*in:	Haomiao Li [verfasserIn] Yingchun Chen [verfasserIn] Hongxia Gao [verfasserIn] Jingjing Chang [verfasserIn] Dai Su [verfasserIn] Shihan Lei [verfasserIn] Di Jiang [verfasserIn] Xiaomei Hu [verfasserIn] Min Tan [verfasserIn] Zhifang Chen [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2019

Schlagwörter:	integrated payment system cerebral infarction direct economic burden readmission rural China

Übergeordnetes Werk:	In: International Journal of Environmental Research and Public Health - MDPI AG, 2005, 16(2019), 9, p 1554
Übergeordnetes Werk:	volume:16 ; year:2019 ; number:9, p 1554

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3390/ijerph16091554

Katalog-ID:	DOAJ009501940

Internformat


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allfields	10.3390/ijerph16091554 doi (DE-627)DOAJ009501940 (DE-599)DOAJcf33a34947da4c4e9fa008cacea52194 DE-627 ger DE-627 rakwb eng Haomiao Li verfasserin aut Effect of an Integrated Payment System on the Direct Economic Burden and Readmission of Rural Cerebral Infarction Inpatients: Evidence from Anhui, China 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Rural China is piloting an integrated payment system, which prepays a budget to a medical alliance rather than a single hospital. This study aims to evaluate the effect of this reform on the direct economic burden and readmission rates of cerebral infarction inpatients. The settlement records of 78,494 cerebral infarction inpatients were obtained from the New Rural Cooperative Medical Scheme (NRCMS) database in Dingyuan and Funan Counties in the Anhui Province. The direct economic burden was estimated by total costs, out-of-pocket expenditures, the out-of-pocket ratio, and the compensation ratio of the NRCMS. Generalized additive models and multivariable linear/logistic regression were applied to measure the changes of the dependent variables along with the year. Within the county, the total costs positively correlated to the year (<i<β</i< = 313.10 in 2015; 163.06 in 2016). The out-of-pocket expenditures, out-of-pocket ratios, and the length-of-stay positively correlated to the year in 2015 (<i<β</i< = 105.10, 0.01, and 0.18 respectively), and negatively correlated to the year in 2016 (<i<β</i< = −58.40, −0.03, and −0.30, respectively). The odds ratios of the readmission rates were less than one within the county (0.70 in 2015; 0.53 in 2016). The integrated payment system in the Anhui Province has considerably reduced the direct economic burden for the rural cerebral infarction inpatients, and the readmission rate has decreased within the county. Inpatients’ health outcomes should be given further attention, and the long-term effect of this reform model awaits further evaluation. integrated payment system cerebral infarction direct economic burden readmission rural China Medicine R Yingchun Chen verfasserin aut Hongxia Gao verfasserin aut Jingjing Chang verfasserin aut Dai Su verfasserin aut Shihan Lei verfasserin aut Di Jiang verfasserin aut Xiaomei Hu verfasserin aut Min Tan verfasserin aut Zhifang Chen verfasserin aut In International Journal of Environmental Research and Public Health MDPI AG, 2005 16(2019), 9, p 1554 (DE-627)477992463 (DE-600)2175195-X 16604601 nnns volume:16 year:2019 number:9, p 1554 https://doi.org/10.3390/ijerph16091554 kostenfrei https://doaj.org/article/cf33a34947da4c4e9fa008cacea52194 kostenfrei https://www.mdpi.com/1660-4601/16/9/1554 kostenfrei https://doaj.org/toc/1660-4601 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_2153 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2019 9, p 1554
spelling	10.3390/ijerph16091554 doi (DE-627)DOAJ009501940 (DE-599)DOAJcf33a34947da4c4e9fa008cacea52194 DE-627 ger DE-627 rakwb eng Haomiao Li verfasserin aut Effect of an Integrated Payment System on the Direct Economic Burden and Readmission of Rural Cerebral Infarction Inpatients: Evidence from Anhui, China 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Rural China is piloting an integrated payment system, which prepays a budget to a medical alliance rather than a single hospital. This study aims to evaluate the effect of this reform on the direct economic burden and readmission rates of cerebral infarction inpatients. The settlement records of 78,494 cerebral infarction inpatients were obtained from the New Rural Cooperative Medical Scheme (NRCMS) database in Dingyuan and Funan Counties in the Anhui Province. The direct economic burden was estimated by total costs, out-of-pocket expenditures, the out-of-pocket ratio, and the compensation ratio of the NRCMS. Generalized additive models and multivariable linear/logistic regression were applied to measure the changes of the dependent variables along with the year. Within the county, the total costs positively correlated to the year (<i<β</i< = 313.10 in 2015; 163.06 in 2016). The out-of-pocket expenditures, out-of-pocket ratios, and the length-of-stay positively correlated to the year in 2015 (<i<β</i< = 105.10, 0.01, and 0.18 respectively), and negatively correlated to the year in 2016 (<i<β</i< = −58.40, −0.03, and −0.30, respectively). The odds ratios of the readmission rates were less than one within the county (0.70 in 2015; 0.53 in 2016). The integrated payment system in the Anhui Province has considerably reduced the direct economic burden for the rural cerebral infarction inpatients, and the readmission rate has decreased within the county. Inpatients’ health outcomes should be given further attention, and the long-term effect of this reform model awaits further evaluation. integrated payment system cerebral infarction direct economic burden readmission rural China Medicine R Yingchun Chen verfasserin aut Hongxia Gao verfasserin aut Jingjing Chang verfasserin aut Dai Su verfasserin aut Shihan Lei verfasserin aut Di Jiang verfasserin aut Xiaomei Hu verfasserin aut Min Tan verfasserin aut Zhifang Chen verfasserin aut In International Journal of Environmental Research and Public Health MDPI AG, 2005 16(2019), 9, p 1554 (DE-627)477992463 (DE-600)2175195-X 16604601 nnns volume:16 year:2019 number:9, p 1554 https://doi.org/10.3390/ijerph16091554 kostenfrei https://doaj.org/article/cf33a34947da4c4e9fa008cacea52194 kostenfrei https://www.mdpi.com/1660-4601/16/9/1554 kostenfrei https://doaj.org/toc/1660-4601 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_2153 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2019 9, p 1554
allfields_unstemmed	10.3390/ijerph16091554 doi (DE-627)DOAJ009501940 (DE-599)DOAJcf33a34947da4c4e9fa008cacea52194 DE-627 ger DE-627 rakwb eng Haomiao Li verfasserin aut Effect of an Integrated Payment System on the Direct Economic Burden and Readmission of Rural Cerebral Infarction Inpatients: Evidence from Anhui, China 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Rural China is piloting an integrated payment system, which prepays a budget to a medical alliance rather than a single hospital. This study aims to evaluate the effect of this reform on the direct economic burden and readmission rates of cerebral infarction inpatients. The settlement records of 78,494 cerebral infarction inpatients were obtained from the New Rural Cooperative Medical Scheme (NRCMS) database in Dingyuan and Funan Counties in the Anhui Province. The direct economic burden was estimated by total costs, out-of-pocket expenditures, the out-of-pocket ratio, and the compensation ratio of the NRCMS. Generalized additive models and multivariable linear/logistic regression were applied to measure the changes of the dependent variables along with the year. Within the county, the total costs positively correlated to the year (<i<β</i< = 313.10 in 2015; 163.06 in 2016). The out-of-pocket expenditures, out-of-pocket ratios, and the length-of-stay positively correlated to the year in 2015 (<i<β</i< = 105.10, 0.01, and 0.18 respectively), and negatively correlated to the year in 2016 (<i<β</i< = −58.40, −0.03, and −0.30, respectively). The odds ratios of the readmission rates were less than one within the county (0.70 in 2015; 0.53 in 2016). The integrated payment system in the Anhui Province has considerably reduced the direct economic burden for the rural cerebral infarction inpatients, and the readmission rate has decreased within the county. Inpatients’ health outcomes should be given further attention, and the long-term effect of this reform model awaits further evaluation. integrated payment system cerebral infarction direct economic burden readmission rural China Medicine R Yingchun Chen verfasserin aut Hongxia Gao verfasserin aut Jingjing Chang verfasserin aut Dai Su verfasserin aut Shihan Lei verfasserin aut Di Jiang verfasserin aut Xiaomei Hu verfasserin aut Min Tan verfasserin aut Zhifang Chen verfasserin aut In International Journal of Environmental Research and Public Health MDPI AG, 2005 16(2019), 9, p 1554 (DE-627)477992463 (DE-600)2175195-X 16604601 nnns volume:16 year:2019 number:9, p 1554 https://doi.org/10.3390/ijerph16091554 kostenfrei https://doaj.org/article/cf33a34947da4c4e9fa008cacea52194 kostenfrei https://www.mdpi.com/1660-4601/16/9/1554 kostenfrei https://doaj.org/toc/1660-4601 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_2153 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2019 9, p 1554
allfieldsGer	10.3390/ijerph16091554 doi (DE-627)DOAJ009501940 (DE-599)DOAJcf33a34947da4c4e9fa008cacea52194 DE-627 ger DE-627 rakwb eng Haomiao Li verfasserin aut Effect of an Integrated Payment System on the Direct Economic Burden and Readmission of Rural Cerebral Infarction Inpatients: Evidence from Anhui, China 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Rural China is piloting an integrated payment system, which prepays a budget to a medical alliance rather than a single hospital. This study aims to evaluate the effect of this reform on the direct economic burden and readmission rates of cerebral infarction inpatients. The settlement records of 78,494 cerebral infarction inpatients were obtained from the New Rural Cooperative Medical Scheme (NRCMS) database in Dingyuan and Funan Counties in the Anhui Province. The direct economic burden was estimated by total costs, out-of-pocket expenditures, the out-of-pocket ratio, and the compensation ratio of the NRCMS. Generalized additive models and multivariable linear/logistic regression were applied to measure the changes of the dependent variables along with the year. Within the county, the total costs positively correlated to the year (<i<β</i< = 313.10 in 2015; 163.06 in 2016). The out-of-pocket expenditures, out-of-pocket ratios, and the length-of-stay positively correlated to the year in 2015 (<i<β</i< = 105.10, 0.01, and 0.18 respectively), and negatively correlated to the year in 2016 (<i<β</i< = −58.40, −0.03, and −0.30, respectively). The odds ratios of the readmission rates were less than one within the county (0.70 in 2015; 0.53 in 2016). The integrated payment system in the Anhui Province has considerably reduced the direct economic burden for the rural cerebral infarction inpatients, and the readmission rate has decreased within the county. Inpatients’ health outcomes should be given further attention, and the long-term effect of this reform model awaits further evaluation. integrated payment system cerebral infarction direct economic burden readmission rural China Medicine R Yingchun Chen verfasserin aut Hongxia Gao verfasserin aut Jingjing Chang verfasserin aut Dai Su verfasserin aut Shihan Lei verfasserin aut Di Jiang verfasserin aut Xiaomei Hu verfasserin aut Min Tan verfasserin aut Zhifang Chen verfasserin aut In International Journal of Environmental Research and Public Health MDPI AG, 2005 16(2019), 9, p 1554 (DE-627)477992463 (DE-600)2175195-X 16604601 nnns volume:16 year:2019 number:9, p 1554 https://doi.org/10.3390/ijerph16091554 kostenfrei https://doaj.org/article/cf33a34947da4c4e9fa008cacea52194 kostenfrei https://www.mdpi.com/1660-4601/16/9/1554 kostenfrei https://doaj.org/toc/1660-4601 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_2153 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2019 9, p 1554
allfieldsSound	10.3390/ijerph16091554 doi (DE-627)DOAJ009501940 (DE-599)DOAJcf33a34947da4c4e9fa008cacea52194 DE-627 ger DE-627 rakwb eng Haomiao Li verfasserin aut Effect of an Integrated Payment System on the Direct Economic Burden and Readmission of Rural Cerebral Infarction Inpatients: Evidence from Anhui, China 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Rural China is piloting an integrated payment system, which prepays a budget to a medical alliance rather than a single hospital. This study aims to evaluate the effect of this reform on the direct economic burden and readmission rates of cerebral infarction inpatients. The settlement records of 78,494 cerebral infarction inpatients were obtained from the New Rural Cooperative Medical Scheme (NRCMS) database in Dingyuan and Funan Counties in the Anhui Province. The direct economic burden was estimated by total costs, out-of-pocket expenditures, the out-of-pocket ratio, and the compensation ratio of the NRCMS. Generalized additive models and multivariable linear/logistic regression were applied to measure the changes of the dependent variables along with the year. Within the county, the total costs positively correlated to the year (<i<β</i< = 313.10 in 2015; 163.06 in 2016). The out-of-pocket expenditures, out-of-pocket ratios, and the length-of-stay positively correlated to the year in 2015 (<i<β</i< = 105.10, 0.01, and 0.18 respectively), and negatively correlated to the year in 2016 (<i<β</i< = −58.40, −0.03, and −0.30, respectively). The odds ratios of the readmission rates were less than one within the county (0.70 in 2015; 0.53 in 2016). The integrated payment system in the Anhui Province has considerably reduced the direct economic burden for the rural cerebral infarction inpatients, and the readmission rate has decreased within the county. Inpatients’ health outcomes should be given further attention, and the long-term effect of this reform model awaits further evaluation. integrated payment system cerebral infarction direct economic burden readmission rural China Medicine R Yingchun Chen verfasserin aut Hongxia Gao verfasserin aut Jingjing Chang verfasserin aut Dai Su verfasserin aut Shihan Lei verfasserin aut Di Jiang verfasserin aut Xiaomei Hu verfasserin aut Min Tan verfasserin aut Zhifang Chen verfasserin aut In International Journal of Environmental Research and Public Health MDPI AG, 2005 16(2019), 9, p 1554 (DE-627)477992463 (DE-600)2175195-X 16604601 nnns volume:16 year:2019 number:9, p 1554 https://doi.org/10.3390/ijerph16091554 kostenfrei https://doaj.org/article/cf33a34947da4c4e9fa008cacea52194 kostenfrei https://www.mdpi.com/1660-4601/16/9/1554 kostenfrei https://doaj.org/toc/1660-4601 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_2153 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2019 9, p 1554
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source	In International Journal of Environmental Research and Public Health 16(2019), 9, p 1554 volume:16 year:2019 number:9, p 1554
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author	Haomiao Li
spellingShingle	Haomiao Li misc integrated payment system misc cerebral infarction misc direct economic burden misc readmission misc rural China misc Medicine misc R Effect of an Integrated Payment System on the Direct Economic Burden and Readmission of Rural Cerebral Infarction Inpatients: Evidence from Anhui, China
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topic_title	Effect of an Integrated Payment System on the Direct Economic Burden and Readmission of Rural Cerebral Infarction Inpatients: Evidence from Anhui, China integrated payment system cerebral infarction direct economic burden readmission rural China
topic	misc integrated payment system misc cerebral infarction misc direct economic burden misc readmission misc rural China misc Medicine misc R
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title	Effect of an Integrated Payment System on the Direct Economic Burden and Readmission of Rural Cerebral Infarction Inpatients: Evidence from Anhui, China
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title_full	Effect of an Integrated Payment System on the Direct Economic Burden and Readmission of Rural Cerebral Infarction Inpatients: Evidence from Anhui, China
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title_sort	effect of an integrated payment system on the direct economic burden and readmission of rural cerebral infarction inpatients: evidence from anhui, china
title_auth	Effect of an Integrated Payment System on the Direct Economic Burden and Readmission of Rural Cerebral Infarction Inpatients: Evidence from Anhui, China
abstract	Rural China is piloting an integrated payment system, which prepays a budget to a medical alliance rather than a single hospital. This study aims to evaluate the effect of this reform on the direct economic burden and readmission rates of cerebral infarction inpatients. The settlement records of 78,494 cerebral infarction inpatients were obtained from the New Rural Cooperative Medical Scheme (NRCMS) database in Dingyuan and Funan Counties in the Anhui Province. The direct economic burden was estimated by total costs, out-of-pocket expenditures, the out-of-pocket ratio, and the compensation ratio of the NRCMS. Generalized additive models and multivariable linear/logistic regression were applied to measure the changes of the dependent variables along with the year. Within the county, the total costs positively correlated to the year (<i<β</i< = 313.10 in 2015; 163.06 in 2016). The out-of-pocket expenditures, out-of-pocket ratios, and the length-of-stay positively correlated to the year in 2015 (<i<β</i< = 105.10, 0.01, and 0.18 respectively), and negatively correlated to the year in 2016 (<i<β</i< = −58.40, −0.03, and −0.30, respectively). The odds ratios of the readmission rates were less than one within the county (0.70 in 2015; 0.53 in 2016). The integrated payment system in the Anhui Province has considerably reduced the direct economic burden for the rural cerebral infarction inpatients, and the readmission rate has decreased within the county. Inpatients’ health outcomes should be given further attention, and the long-term effect of this reform model awaits further evaluation.
abstractGer	Rural China is piloting an integrated payment system, which prepays a budget to a medical alliance rather than a single hospital. This study aims to evaluate the effect of this reform on the direct economic burden and readmission rates of cerebral infarction inpatients. The settlement records of 78,494 cerebral infarction inpatients were obtained from the New Rural Cooperative Medical Scheme (NRCMS) database in Dingyuan and Funan Counties in the Anhui Province. The direct economic burden was estimated by total costs, out-of-pocket expenditures, the out-of-pocket ratio, and the compensation ratio of the NRCMS. Generalized additive models and multivariable linear/logistic regression were applied to measure the changes of the dependent variables along with the year. Within the county, the total costs positively correlated to the year (<i<β</i< = 313.10 in 2015; 163.06 in 2016). The out-of-pocket expenditures, out-of-pocket ratios, and the length-of-stay positively correlated to the year in 2015 (<i<β</i< = 105.10, 0.01, and 0.18 respectively), and negatively correlated to the year in 2016 (<i<β</i< = −58.40, −0.03, and −0.30, respectively). The odds ratios of the readmission rates were less than one within the county (0.70 in 2015; 0.53 in 2016). The integrated payment system in the Anhui Province has considerably reduced the direct economic burden for the rural cerebral infarction inpatients, and the readmission rate has decreased within the county. Inpatients’ health outcomes should be given further attention, and the long-term effect of this reform model awaits further evaluation.
abstract_unstemmed	Rural China is piloting an integrated payment system, which prepays a budget to a medical alliance rather than a single hospital. This study aims to evaluate the effect of this reform on the direct economic burden and readmission rates of cerebral infarction inpatients. The settlement records of 78,494 cerebral infarction inpatients were obtained from the New Rural Cooperative Medical Scheme (NRCMS) database in Dingyuan and Funan Counties in the Anhui Province. The direct economic burden was estimated by total costs, out-of-pocket expenditures, the out-of-pocket ratio, and the compensation ratio of the NRCMS. Generalized additive models and multivariable linear/logistic regression were applied to measure the changes of the dependent variables along with the year. Within the county, the total costs positively correlated to the year (<i<β</i< = 313.10 in 2015; 163.06 in 2016). The out-of-pocket expenditures, out-of-pocket ratios, and the length-of-stay positively correlated to the year in 2015 (<i<β</i< = 105.10, 0.01, and 0.18 respectively), and negatively correlated to the year in 2016 (<i<β</i< = −58.40, −0.03, and −0.30, respectively). The odds ratios of the readmission rates were less than one within the county (0.70 in 2015; 0.53 in 2016). The integrated payment system in the Anhui Province has considerably reduced the direct economic burden for the rural cerebral infarction inpatients, and the readmission rate has decreased within the county. Inpatients’ health outcomes should be given further attention, and the long-term effect of this reform model awaits further evaluation.
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container_issue	9, p 1554
title_short	Effect of an Integrated Payment System on the Direct Economic Burden and Readmission of Rural Cerebral Infarction Inpatients: Evidence from Anhui, China
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This study aims to evaluate the effect of this reform on the direct economic burden and readmission rates of cerebral infarction inpatients. The settlement records of 78,494 cerebral infarction inpatients were obtained from the New Rural Cooperative Medical Scheme (NRCMS) database in Dingyuan and Funan Counties in the Anhui Province. The direct economic burden was estimated by total costs, out-of-pocket expenditures, the out-of-pocket ratio, and the compensation ratio of the NRCMS. Generalized additive models and multivariable linear/logistic regression were applied to measure the changes of the dependent variables along with the year. Within the county, the total costs positively correlated to the year (<i<β</i< = 313.10 in 2015; 163.06 in 2016). The out-of-pocket expenditures, out-of-pocket ratios, and the length-of-stay positively correlated to the year in 2015 (<i<β</i< = 105.10, 0.01, and 0.18 respectively), and negatively correlated to the year in 2016 (<i<β</i< = −58.40, −0.03, and −0.30, respectively). The odds ratios of the readmission rates were less than one within the county (0.70 in 2015; 0.53 in 2016). The integrated payment system in the Anhui Province has considerably reduced the direct economic burden for the rural cerebral infarction inpatients, and the readmission rate has decreased within the county. 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Effect of an Integrated Payment System on the Direct Economic Burden and Readmission of Rural Cerebral Infarction Inpatients: Evidence from Anhui, China

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