Abstract
BackgroundSingle disease payment program based on clinical pathway (CP-based SDP) plays an increasingly important role in reducing health expenditure in china and there is a clear need to explore the scheme from different perspectives. This study aimed at evaluating the effect of the scheme in rural county public hospitals within Anhui, a typical province of China,using uterine leiomyoma as an example.MethodsThe study data were extracted from the data platform of the New Rural Cooperative Medical Office of Anhui Province using stratified-random sampling. Means, constituent ratios and coefficients of variations were calculated and/or compared between control versus experiment groups and between different years.ResultsThe total hospitalization expenditure (per-time) dropped from 919.08 ± 274.92 USD to 834.91 ± 225.29 USD and length of hospital stay reduced from 9.96 ± 2.39 days to 8.83 ± 1.95 days(P < 0.01), after CP-based SDP had implemented. The yearly total hospitalization expenditure manifested an atypical U-shaped trend. Medicine expense, nursing expense, assay cost and treatment cost reduced; while the fee of operation and examination increased (P < 0.05). The expense constituent ratios of medicine, assay and treatment decreased with the medicine expense dropped the most (by 4.4%). The expense constituent ratios of materials, ward, operation, examination and anesthetic increased,with the examination fee elevated the most (by 3.9%).The coefficient of variation(CVs) of treatment cost declined the most (− 0.360); while the CV of materials expense increased the most (0.186).ConclusionThere existed huge discrepancies in inpatient care for uterine leiomyoma patients. Implementation of CP-based SDP can help not only in controlling hospitalization costs of uterine leiomyoma in county-level hospitals but also in standardizing the diagnosis and treatment procedures.
Highlights
Single disease payment program based on clinical pathway (CP-based SDP) plays an increasingly important role in reducing health expenditure in china and there is a clear need to explore the scheme from different perspectives
The length of hospital stay decreased, the economic burden on those not paid by SDP increased. Based on these previous findings/observations, the general aim of our study is to expand the analysis of the effects of SDP based on clinical pathway, to see what would the effect of the two combined mechanisms be like and how is the outcome can contribute to the current existing problems in rural areas
Reduction in total hospitalization expenditure and length of hospital stay Our analysis revealed that average total hospitalization expenditure of the experimental group was
Summary
This study aimed at evaluating the effect of the scheme in rural county public hospitals within Anhui, a typical province of China,using uterine leiomyoma as an example. Based on these previous findings/observations, the general aim of our study is to expand the analysis of the effects of SDP based on clinical pathway, to see what would the effect of the two combined mechanisms be like and how is the outcome can contribute to the current existing problems in rural areas
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