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Tytuł:
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Comparison of inpatient distribution amongst different medical alliances in a county: a longitudinal study on a healthcare reform in rural China.
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Autorzy:
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Ran Y; School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.; Research Centre for Rural Health Service, Key Research Institute of Humanities and Social Sciences of Hubei Provincial Department of Education, Wuhan, 430030, Hubei, China.
Gao H; School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. .; Research Centre for Rural Health Service, Key Research Institute of Humanities and Social Sciences of Hubei Provincial Department of Education, Wuhan, 430030, Hubei, China. .
Han D; School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.; Research Centre for Rural Health Service, Key Research Institute of Humanities and Social Sciences of Hubei Provincial Department of Education, Wuhan, 430030, Hubei, China.
Hou G; School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.; Research Centre for Rural Health Service, Key Research Institute of Humanities and Social Sciences of Hubei Provincial Department of Education, Wuhan, 430030, Hubei, China.
Chen Y; School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.; Research Centre for Rural Health Service, Key Research Institute of Humanities and Social Sciences of Hubei Provincial Department of Education, Wuhan, 430030, Hubei, China.
Zhang Y; School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.; Research Centre for Rural Health Service, Key Research Institute of Humanities and Social Sciences of Hubei Provincial Department of Education, Wuhan, 430030, Hubei, China.
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Źródło:
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International journal for equity in health [Int J Equity Health] 2020 Aug 20; Vol. 19 (1), pp. 142. Date of Electronic Publication: 2020 Aug 20.
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Typ publikacji:
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Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Original Publication: [London] : BioMed Central, 2002-
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MeSH Terms:
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Health Care Reform*
Health Equity*
Hospitalization*/statistics & numerical data
Hospitals, County*/statistics & numerical data
Resource Allocation*
Rural Population*
China ; Delivery of Health Care/organization & administration ; Health Status Disparities ; Healthcare Disparities ; Hospitals ; Humans ; Inpatients ; Interrupted Time Series Analysis ; Longitudinal Studies
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References:
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Contributed Indexing:
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Keywords: Health inequality; Inpatient distribution; Interrupted time series analysis (ITSA); Medical alliances (MAs); Rural health
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Entry Date(s):
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Date Created: 20200822 Date Completed: 20210112 Latest Revision: 20210112
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Update Code:
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20240105
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PubMed Central ID:
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PMC7441726
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DOI:
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10.1186/s12939-020-01260-x
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PMID:
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32819362
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Background: China has launched the medical alliances (MAs) reform to drive the development of primary medical institutions and decrease health inequality in rural areas. Three different types of MAs were built to promote township hospitals in Y County. This study aims to evaluate the actual effect of China's MAs reform in rural areas on inpatient distribution especially amongst different types of MAs.
Methods: We obtain 2008-2015 claims data from the New Cooperative Medical Scheme (NCMS) in Y County, Hubei Province of China. We consider January 2008-December 2010 as the pre-reform period and January 2011-December 2015 as the post-reform period. We use independent sample t-test and single-group interrupted time series analysis (ITSA) to compare the number of inpatients per month in the three MAs, including three county and 10 township hospitals before and after the reform. We use paired t-test and multiple-group ITSA between seven township hospitals within MAs and seven township hospitals outside MAs.
Results: The MAs reform in Y County increased the number of inpatients in county and township hospitals within MAs. After the reform, the number of inpatients per month in county hospitals had an upward trend, with a slope of 31.01 person/month (P < 0.000). Approximately 19.99 new inpatients were admitted to township hospitals monthly after the reform (P < 0.000). Furthermore, township hospitals within MAs had a substantial increase in the number of inpatients (10.45 new inpatients monthly) compared with those outside MAs.
Conclusion: The MAs reform in Y County significantly improved the capability of medical institutions within MAs. After the reform, township hospitals within MAs had greater development advantages than those outside MAs. However, it also caused further imbalance in the county region, which contained the new health inequality risk.
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