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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.

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.

Suggested Citation

  • Chang, Ray-E. & Hsieh, Chi-Jeng & Myrtle, Robert C., 2011. "The effect of outpatient dialysis global budget cap on healthcare utilization by end-stage renal disease patients," Social Science & Medicine, Elsevier, vol. 73(1), pages 153-159, July.
  • Handle: RePEc:eee:socmed:v:73:y:2011:i:1:p:153-159
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    References listed on IDEAS

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    4. Cutler, David M, 1995. "The Incidence of Adverse Medical Outcomes under Prospective Payment," Econometrica, Econometric Society, vol. 63(1), pages 29-50, January.
    5. Avi Dor & Mark Pauly & Margaret Eichleay & Philip Held, 2007. "End-stage renal disease and economic incentives: the International Study of Health Care Organization and Financing (ISHCOF)," International Journal of Health Economics and Management, Springer, vol. 7(2), pages 73-111, September.
    6. James M. Poterba, 1994. "A Skeptic's View of Global Budget Caps," Journal of Economic Perspectives, American Economic Association, vol. 8(3), pages 67-73, Summer.
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    10. Avi Dor & Mark V. Pauly & Margaret A. Eichleay & Philip J. Held, 2007. "End-stage Renal Disease and Economic Incentives: The International Study of Health Care Organization and Financing," NBER Working Papers 13125, National Bureau of Economic Research, Inc.
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