A comparative study of hospitalization costs of TKA inpatients before and after National Volume-based Procurement in Guangdong, China: an interrupted time-series analysis
BackgroundThis study aims to explore the impact of the National Volume-based Procurement Policy in Guangdong Province on hospitalization costs for total knee arthroplasty inpatients.MethodsInterrupted time-series analysis were used to examine the expenses associated with total knee arthroplasty for...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-01-01
|
| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1468606/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832584509456908288 |
|---|---|
| author | Anqi Li Gongduan Li Dong Han Manru Fu Jinghui Chang Jinghui Chang |
| author_facet | Anqi Li Gongduan Li Dong Han Manru Fu Jinghui Chang Jinghui Chang |
| author_sort | Anqi Li |
| collection | DOAJ |
| description | BackgroundThis study aims to explore the impact of the National Volume-based Procurement Policy in Guangdong Province on hospitalization costs for total knee arthroplasty inpatients.MethodsInterrupted time-series analysis were used to examine the expenses associated with total knee arthroplasty for inpatients at a hospital in Guangzhou between May 10, 2021, and December 26, 2023. The period was divided into two phases based on the implementation of the policy, the pre-policy phase (May 10, 2021, to April 30, 2022) and the post-policy phase (May 1, 2022, to December 26, 2023). A total of ten indicators, derived from patients’ medical records, were analyzed. Indicators included total expenses, self-financed expenses, consumables costs, miscellaneous service fees, diagnostic fees, treatment fees, rehabilitation fees, total Chinese medicine costs, western medicine costs, and the costs of blood and blood products.ResultsA total of 1,196 valid cases were included, with 290 cases before policy implementation and 906 cases after implementation. When the implementation of procurement occurred (May 1, 2022), total expenses (β2= − 28240.17, p < 0.001), consumables costs (β2= − 31302.72, p < 0.001), and self-financed expenses (β2= − 13674.56, p<0.001) showed an instantaneous decreasing trend. The mean total expenses decreased from 65,324.73 CNY per case to 34,465.57 CNY per case, representing a reduction of 30,859.16 CNY per case. Miscellaneous service fees (β2= 440.45, p < 0.05), diagnostic fees (β2=746.00, p < 0.05), rehabilitation fees (β2=207.36, p < 0.001) exhibited an instantaneous and slight increasing trend. After implementation (from May 1, 2022 to December 26, 2023), the total expenses (β3=−106.95, p<0.05), consumables costs (β3= − 65.05, p<0.05), diagnostic fees (β3= − 22.44, p < 0.05), treatment fees (β3= − 28.01, p < 0.05), total Chinese medicine costs (β3= − 9.98, p < 0.05), and blood and blood products costs (β3= − 5.88, p<0.05) continued to decrease.ConclusionThe volume-based procurement policy in Guangdong, China has shown initial effectiveness. After it was implemented, total expenses, consumables costs, and self-financed expenses decreased. The structure of hospitalization costs also reflects the slight improvement in healthcare providers’ value and treatment planning decisions. Further attention should be given to the healthcare professionals’ labor value. The empirical analysis results provide a reference for the government further to improve the volume-based procurement for artificial joints. |
| format | Article |
| id | doaj-art-329f89b0fd9c47708f3542d340928638 |
| institution | Kabale University |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-329f89b0fd9c47708f3542d3409286382025-01-27T13:04:06ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-01-011210.3389/fpubh.2024.14686061468606A comparative study of hospitalization costs of TKA inpatients before and after National Volume-based Procurement in Guangdong, China: an interrupted time-series analysisAnqi Li0Gongduan Li1Dong Han2Manru Fu3Jinghui Chang4Jinghui Chang5School of Health Management, Southern Medical University, Guangzhou, ChinaFaculty of Biology, Medicine and Health, The University of Manchester, Manchester, United KingdomThe Third Affiliated Hospital of Southern Medical University, Guangzhou, ChinaThe Third Affiliated Hospital of Southern Medical University, Guangzhou, ChinaSchool of Health Management, Southern Medical University, Guangzhou, ChinaDepartment of Global Health and Population, Harvard Chan School of Public Health, Harvard University, Boston, MA, United StatesBackgroundThis study aims to explore the impact of the National Volume-based Procurement Policy in Guangdong Province on hospitalization costs for total knee arthroplasty inpatients.MethodsInterrupted time-series analysis were used to examine the expenses associated with total knee arthroplasty for inpatients at a hospital in Guangzhou between May 10, 2021, and December 26, 2023. The period was divided into two phases based on the implementation of the policy, the pre-policy phase (May 10, 2021, to April 30, 2022) and the post-policy phase (May 1, 2022, to December 26, 2023). A total of ten indicators, derived from patients’ medical records, were analyzed. Indicators included total expenses, self-financed expenses, consumables costs, miscellaneous service fees, diagnostic fees, treatment fees, rehabilitation fees, total Chinese medicine costs, western medicine costs, and the costs of blood and blood products.ResultsA total of 1,196 valid cases were included, with 290 cases before policy implementation and 906 cases after implementation. When the implementation of procurement occurred (May 1, 2022), total expenses (β2= − 28240.17, p < 0.001), consumables costs (β2= − 31302.72, p < 0.001), and self-financed expenses (β2= − 13674.56, p<0.001) showed an instantaneous decreasing trend. The mean total expenses decreased from 65,324.73 CNY per case to 34,465.57 CNY per case, representing a reduction of 30,859.16 CNY per case. Miscellaneous service fees (β2= 440.45, p < 0.05), diagnostic fees (β2=746.00, p < 0.05), rehabilitation fees (β2=207.36, p < 0.001) exhibited an instantaneous and slight increasing trend. After implementation (from May 1, 2022 to December 26, 2023), the total expenses (β3=−106.95, p<0.05), consumables costs (β3= − 65.05, p<0.05), diagnostic fees (β3= − 22.44, p < 0.05), treatment fees (β3= − 28.01, p < 0.05), total Chinese medicine costs (β3= − 9.98, p < 0.05), and blood and blood products costs (β3= − 5.88, p<0.05) continued to decrease.ConclusionThe volume-based procurement policy in Guangdong, China has shown initial effectiveness. After it was implemented, total expenses, consumables costs, and self-financed expenses decreased. The structure of hospitalization costs also reflects the slight improvement in healthcare providers’ value and treatment planning decisions. Further attention should be given to the healthcare professionals’ labor value. The empirical analysis results provide a reference for the government further to improve the volume-based procurement for artificial joints.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1468606/fulltotal knee arthroplastyNational Volume-Based Procurementinterrupt time series analysiscost comparisonhealthcare policy |
| spellingShingle | Anqi Li Gongduan Li Dong Han Manru Fu Jinghui Chang Jinghui Chang A comparative study of hospitalization costs of TKA inpatients before and after National Volume-based Procurement in Guangdong, China: an interrupted time-series analysis Frontiers in Public Health total knee arthroplasty National Volume-Based Procurement interrupt time series analysis cost comparison healthcare policy |
| title | A comparative study of hospitalization costs of TKA inpatients before and after National Volume-based Procurement in Guangdong, China: an interrupted time-series analysis |
| title_full | A comparative study of hospitalization costs of TKA inpatients before and after National Volume-based Procurement in Guangdong, China: an interrupted time-series analysis |
| title_fullStr | A comparative study of hospitalization costs of TKA inpatients before and after National Volume-based Procurement in Guangdong, China: an interrupted time-series analysis |
| title_full_unstemmed | A comparative study of hospitalization costs of TKA inpatients before and after National Volume-based Procurement in Guangdong, China: an interrupted time-series analysis |
| title_short | A comparative study of hospitalization costs of TKA inpatients before and after National Volume-based Procurement in Guangdong, China: an interrupted time-series analysis |
| title_sort | comparative study of hospitalization costs of tka inpatients before and after national volume based procurement in guangdong china an interrupted time series analysis |
| topic | total knee arthroplasty National Volume-Based Procurement interrupt time series analysis cost comparison healthcare policy |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1468606/full |
| work_keys_str_mv | AT anqili acomparativestudyofhospitalizationcostsoftkainpatientsbeforeandafternationalvolumebasedprocurementinguangdongchinaaninterruptedtimeseriesanalysis AT gongduanli acomparativestudyofhospitalizationcostsoftkainpatientsbeforeandafternationalvolumebasedprocurementinguangdongchinaaninterruptedtimeseriesanalysis AT donghan acomparativestudyofhospitalizationcostsoftkainpatientsbeforeandafternationalvolumebasedprocurementinguangdongchinaaninterruptedtimeseriesanalysis AT manrufu acomparativestudyofhospitalizationcostsoftkainpatientsbeforeandafternationalvolumebasedprocurementinguangdongchinaaninterruptedtimeseriesanalysis AT jinghuichang acomparativestudyofhospitalizationcostsoftkainpatientsbeforeandafternationalvolumebasedprocurementinguangdongchinaaninterruptedtimeseriesanalysis AT jinghuichang acomparativestudyofhospitalizationcostsoftkainpatientsbeforeandafternationalvolumebasedprocurementinguangdongchinaaninterruptedtimeseriesanalysis AT anqili comparativestudyofhospitalizationcostsoftkainpatientsbeforeandafternationalvolumebasedprocurementinguangdongchinaaninterruptedtimeseriesanalysis AT gongduanli comparativestudyofhospitalizationcostsoftkainpatientsbeforeandafternationalvolumebasedprocurementinguangdongchinaaninterruptedtimeseriesanalysis AT donghan comparativestudyofhospitalizationcostsoftkainpatientsbeforeandafternationalvolumebasedprocurementinguangdongchinaaninterruptedtimeseriesanalysis AT manrufu comparativestudyofhospitalizationcostsoftkainpatientsbeforeandafternationalvolumebasedprocurementinguangdongchinaaninterruptedtimeseriesanalysis AT jinghuichang comparativestudyofhospitalizationcostsoftkainpatientsbeforeandafternationalvolumebasedprocurementinguangdongchinaaninterruptedtimeseriesanalysis AT jinghuichang comparativestudyofhospitalizationcostsoftkainpatientsbeforeandafternationalvolumebasedprocurementinguangdongchinaaninterruptedtimeseriesanalysis |