期刊
SOCIAL SCIENCE & MEDICINE
卷 73, 期 1, 页码 153-159出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.socscimed.2011.05.007
关键词
Outpatient global budget cap; Outpatient dialysis; End-stage renal disease; Healthcare utilization; Taiwan; Chronic illness
资金
- Taiwan's Ministry of Education [MOD ATU 99RH0021]
- Department of Health [DOH94-CA-1001]
Controlling the cost of chronic diseases remains one of the vexing problems of developed and developing nations alike. Taiwan, faced with rapidly escalating healthcare costs associated with End Stage Renal Disease (ESRD) services utilization, imposed an outpatient dialysis global budget (ODBG) on outpatient dialysis care. This study, using a before and after study design with a comparison group, assessed the impact of this policy innovation on outpatient, inpatient and emergency room utilization. Using a difference in difference (DID) strategy and the generalized estimating equation (GEE) approach, this study found providers responded to these changes through cost reduction and revenue enhancement strategies. This study extends our understanding of provider responses to changes in reimbursement policies that target one segment of the continuum of care required by chronic disease patients. (C) 2011 Elsevier Ltd. All rights reserved.
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