The effect of outpatient dialysis global budget cap on healthcare utilization by end-stage renal disease patients
Journal
Social Science and Medicine
Journal Volume
73
Journal Issue
1
Pages
153-159
Date Issued
2011
Author(s)
Abstract
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. ? 2011 Elsevier Ltd.
Subjects
Chronic illness; End-stage renal disease; Healthcare utilization; Outpatient dialysis; Outpatient global budget cap; Taiwan
SDGs
Other Subjects
disease treatment; estimation method; health care; health policy; policy analysis; policy implementation; service provision; adult; aged; article; budget; controlled study; cost control; emergency ward; female; health care cost; health care policy; health care utilization; hemodialysis; hospital care; human; kidney failure; major clinical study; male; outpatient care; reimbursement; renal replacement therapy; Taiwan; Adult; Aged; Ambulatory Care; Budgets; Dialysis; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Patient Compliance; Regression Analysis; Taiwan
Type
journal article