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

Listed author(s):
  • Chang, Ray-E.
  • Hsieh, Chi-Jeng
  • Myrtle, Robert C.
Registered author(s):

    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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    File URL: http://www.sciencedirect.com/science/article/pii/S0277953611002814
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    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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    1. Mougeot, Michel & Naegelen, Florence, 2005. "Hospital price regulation and expenditure cap policy," Journal of Health Economics, Elsevier, vol. 24(1), pages 55-72, January.
    2. repec:mpr:mprres:3869 is not listed on IDEAS
    3. Mitchell, Jean M. & Sass, Tim R., 1995. "Physician ownership of ancillary services: Indirect demand inducement or quality assurance?," Journal of Health Economics, Elsevier, vol. 14(3), pages 263-289, August.
    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. Fan, Chinn-Ping & Chen, Kong-Pin & Kan, Kamhon, 1998. "The design of payment systems for physicians under global budget - an experimental study," Journal of Economic Behavior & Organization, Elsevier, vol. 34(2), pages 295-311, February.
    6. 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.
    7. 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.
    8. Miaw-Chwen Lee & Andrew M. Jones, 2004. "How did Dentists Respond to the Introduction of Global Budgets in Taiwan? An Evaluation Using Individual Panel Data," International Journal of Health Economics and Management, Springer, vol. 4(4), pages 307-326, December.
    9. Benstetter, Franz & Wambach, Achim, 2006. "The treadmill effect in a fixed budget system," Journal of Health Economics, Elsevier, vol. 25(1), pages 146-169, January.
    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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