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The effect of outpatient dialysis global budget cap on healthcare utilization by end-stage renal disease patients

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  • Chang, Ray-E.
  • Hsieh, Chi-Jeng
  • Myrtle, Robert C.
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    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.

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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 73 (2011)
    Issue (Month): 1 (July)
    Pages: 153-159

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    Handle: RePEc:eee:socmed:v:73:y:2011:i:1:p:153-159

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    Related research

    Keywords: Outpatient global budget cap Outpatient dialysis End-stage renal disease Healthcare utilization Taiwan Chronic illness;

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