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Effect of the new maternity insurance scheme on medical expenditures for caesarean delivery in Wuxi, China： a retrospective pre/post-reform case study

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Frontiers of Medicine 2016年第4期10卷 473-480页

作者： Chun Chen Zhihong Cheng Ping Jiang Mei Sun Qi Zhang Jun Lv School of Public Health and Management Wenzhou Medical University Wenzhou 325035 China Research Institute of Health Development Strategies Fudan University Shanghai 200032 China Affiliated Hospital Jiangnan University Wuxi 214062 China School of Community and Environmental Health Old Dominion University Norfolk VA 23529 USA

Aiming to control rising medical expenditures and help improve China＇s healthcare systems, this study examined whether a cap-based medical insurance scheme with shared financial interest between the insurance and healthcare providers is effective in containing hospitals＇ C-section medical expenditures. We used 6547 caesarean delivery case records from a teaching tertiary-level general public hospital located in Wuxi, China （2004-2013）, and used the Chow test to investigate the possibility of significant variation in mean medical expenditures for caesarean deliveries pre- and post-reform. We also used paired sample t-tests and linear regression models to compare the mean medical expenditures between insured and uninsured women undergoing caesarean delivery during the post-reform period. After the scheme＇s implementation, medical expenditures for caesarean deliveries declined and the medical expenditures of women covered by the scheme were significantly lower than those of uninsured patients. These findings indicated the scheme＇s effectiveness in minimizing caesarean delivery expenditures. The cap-based medical insurance scheme with shared financial interest between insurance and healthcare providers would likely steer healtbcare providers＇ behaviors in a more cost-effective direction.

关键词： matemity insurance scheme financial incentive caesarean delivery medical expenditure China

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