RAY-E CHANGChang, Ray-E.Ray-E.ChangHsieh, Chi-JengChi-JengHsiehMyrtle, Robert C.Robert C.Myrtle2018-09-102018-09-102011http://www.scopus.com/inward/record.url?eid=2-s2.0-79959587989&partnerID=MN8TOARShttp://scholars.lib.ntu.edu.tw/handle/123456789/367012Controlling 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.Chronic illness; End-stage renal disease; Healthcare utilization; Outpatient dialysis; Outpatient global budget cap; Taiwan[SDGs]SDG3disease 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; Taiwanjournal article10.1016/j.socscimed.2011.05.007