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Table 2 Impact of payment reform on cesarean delivery rate, costs of childbirth per admission, length of stay and rate of readmission: average estimates

From: Cesarean delivery rates, costs and readmission of childbirth in the new cooperative medical scheme after implementation of an episode-based bundled payment (EBP) policy

  Reform county Control counties DID
Pre Post Diff Pre Post Diff
Cesarean delivery rate, % 35.50 37.90 2.40* 39.00 51.50 12.50** −10.10
Total spending (¥) 2847.42 [2295.65] 3023.49 [2606.99] 176.07** 2886.27 [1894.56] 3711.95 [2040.98] 825.68** −649.61
Government expenses (¥) 955.24 [709.99] 1181.57 [1139.67] 226.33** 889.59 [709.25] 1690.93 [1201.82] 801.34** −575.01
OOPa payments (¥) 1892.18 [1654.14] 1841.92 [1643.38] −50.25 1996.68 [1372.69] 2021.02 [1242.78] 24.34 −74.59
OOPa payments as a share of total spending,% 62.82 [9.64] 59.62 [10.03] −3.20** 68.90 [14.10] 57.28 [18.17] −11.62** 8.41
Drug cost (¥) 536.26 [684.09] 377.12 [616.97] −159.14** 559.02 [667.99] 594.07 [662.95] 35.05** − 194.19
Diagnostic testing cost (¥) 225.41 [226.74] 246.13 [275.13] 20.72** 176.95 [171.13] 225.24 [214.23] 48.29** −27.57
Physician services and therapeutic services cost (¥) 2085.75 [1482.30] 2400.24 [1839.96] 314.50** 2150.31 [1243.58] 2892.64 [1449.86] 742.34** − 427.84
LOSb, days 9.57 [5.92] 7.85 [4.63] −1.72** 6.58 [2.82] 7.00 [3.01] 0.02** −1.74
30 day readmission rate, % 0.60 1.00 0.40 0.50 0.50 0.00 0.40
60 day readmission rate, % 0.80 1.30 0.50 0.70 0.90 0.20 0.30
  1. ‘Pre’ is January 2010–August 2011; ‘Post’ is September 2011–March 2013; Diff is after minus before; DID is diff for reform county minus diff for control counties. The number of observations is 3269 in January 2010–August 2011 and 3556 in September 2011–March 2013 for reform county, and 5108 in January 2010–August 2011 and 5389 in September 2011–March 2013 for control counties. S.D. are in square brackets. aOOP: Out-of-pocket; bLOS: Length of stay. *p<0.05; **p<0.01