Table 1
Comparison of Sanming’s IMPM with other areas of China.
| AREA | SANMING | OTHER AREAS OF CHINA |
|---|---|---|
| Policy goals | Save medical insurance funds;Promote cooperation;Promote residents’ health | Save medical insurance funds;Promote cooperation;Promote residents’ health |
| The payment policies for ICHC | ||
| (1) How to set GB? | According to population | According to population and ICHC’s medical insurance expenditure in previous years |
| (2) How to use GB? | ICHC owns the over-spending | ICHC shares the over-spending with medical insurance management institutions |
| The balance can be used for institutional development, payment of doctor’ salary, cooperation among medical institutions, and health promotion | The balance can be used only for institutional development | |
| The payment policies for medical personnel | Paid by ASS. The evaluation indexes of ASS were adjusted according to IMPM goals | Paid by volume of service. The volumes of service were adjusted according to IMPM goals |
| Promoting the cooperation of medical institutions and residents’ health is one of the main evaluation criteria for medical personnel’s salary level | Even if they do not promote cooperation between medical institutions and residents’ health, medical personnel can get a high level of income |
[i] Note: This table illustrates the general situation only. Integrated payment policies in other parts of China may be quite different.
Table 2
Social economic status and other characteristics of Youxi from 2016 to 2019.
| INDICATORS | 2016 | 2017 | 2018 | 2019 |
|---|---|---|---|---|
| Total area (km2) | 3463 | |||
| GDP (billion RMB) | 20.1 | 23.1 | 24.6 | 26.3 |
| Resident population (10000) | 35.8 | 36.1 | 36.2 | 36.3 |
| The proportion of the population aged 60 and above (%) | 14.9 | 15.3 | 15.9 | 16.6 |
| Per capita disposable income (RMB) | 19687 | 21509 | 23067 | 25410 |
| Number of CHs | 3 | 3 | 3 | 3 |
| Number of THs | 18 | 18 | 23 | 23 |
| Number of HCs | 350 | 354 | 387 | 363 |
| Number of ICHC | 0 | 1 | 1 | 1 |
| Number of health personnel per 1000 | 5.96 | 6.21 | 5.28 | 4.97 |
| Number of practicing physicians per 1000 | 1.54 | 1.73 | 2.25 | 2.34 |
| Number of registered nurses per 1000 | 1.83 | 2.01 | 2.32 | 2.63 |
| Number of hospital beds per 1000 | 4.16 | 4.42 | 4.53 | 4.80 |
[i] Note: GDP, Gross Domestic Product; RMB, Ren Min Bi.
Figure 1
The geolocation of Youxi in Fujian Province, China.
Table 3
Interrupted time series analysis of outcome variables in CHS of ICHC.
| OUTCOME VARIABLES | β_1, LEVEL CHANGE | β_2, LEVEL CHANGE | β_3, TREND/SLOPE CHANGE | |||
|---|---|---|---|---|---|---|
| P VALUE | (95% CI) | P VALUE | (95% CI) | P VALUE | (95% CI) | |
| Number of outpatient and emergency patients | 0.000 | 578.3 (462.5 to 694.1) | 0.022 | –2470.3 (–4572.9 to –367.7) | 0.000 | –459.9 (–596.5 to –323.3) |
| Number of hospitalizations | 0.000 | 17.9 (11.7 to 24.2) | 0.000 | –286.0 (–406.8 to –165.1) | 0.000 | –18.1 (–26.8 to –9.4) |
| Cost of outpatient and emergency patients per time | 0.000 | –0.9 (–1.3 to –0.4) | 0.008 | 15.9 (4.3 to 27.5) | 0.000 | 2.0 (1.1 to 2.9) |
| Cost of hospitalization per time | 0.451 | 6.4 (–10.6 to 23.4) | 0.456 | 100.1 (–168.1 to 368.7) | 0.083 | 18.7 (–2.5 to 39.9) |
Figure 2
Outcome variables in CHs of ICHC.