How Did Zero-Markup Medicines Policy Change Prescriptions in the Eyes of Patients?—A Retrospective Quasi-Experimental Analysis
Abstract
:1. Background
2. Methods
2.1. Study Design
2.2. Data Source
2.3. Participants and Setting
2.4. Measurement
2.5. Statistical Analysis
3. Results
3.1. Responded Outpatients Included in the Study before and after Performing the PSM
3.2. Regression Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Model 1 (Baseline Pooled Logit) | Model 2 (Logit DID) | Model 3 (PSM Logit DID) | Model 4 (PSM Logit DID Hospital Fixed-Effect) | ||||
---|---|---|---|---|---|---|---|---|
Coef | SE | Coef | SE | Coef | SE | Coef | SE | |
Policy (Control group as reference) | 0.22 *** | 0.04 | −0.36 *** | 0.06 | −0.36 *** | 0.06 | −0.15 | 0.16 |
Time (2015 as reference) | 0.07 * | 0.04 | −0.30 *** | 0.05 | −0.31 *** | 0.05 | −0.31 | 0.22 |
Policy × Time | / | / | 1.30 *** | 0.09 | 1.30 *** | 0.09 | 1.35 *** | 0.38 |
Gender (Female as reference) | −0.14 *** | 0.05 | −0.14 *** | 0.05 | −1.33 *** | 0.05 | −0.13 *** | 0.05 |
Age (Younger than 18 years old as reference) | ||||||||
18–35 years old | −0.38 * | 0.21 | −0.37 * | 0.21 | −0.36 * | 0.21 | −0.38 | 0.27 |
36–50 years old | −0.27 | 0.21 | −027. | 0.21 | −0.25 | 0.21 | −0.29 | 0.27 |
51–65 years old | −0.28 | 0.22 | −0.31 | 0.22 | −0.29 | 0.22 | −0.38 | 0.27 |
Older than 65 years old | −0.26 | 0.22 | −0.30 | 0.22 | −0.29 | 0.22 | −0.27 | 0.29 |
Education (Postgraduate and above as reference) | ||||||||
Undergraduate | 0.18 ** | 0.09 | 0.20 ** | 0.09 | 0.20 ** | 0.09 | 0.32 *** | 0.10 |
Technical school | 0.18 * | 0.10 | 0.18 * | 0.10 | 0.18 * | 0.10 | 0.33 ** | 0.13 |
High school | 0.16 | 0.10 | 0.18 * | 0.10 | 0.18 * | 0.10 | 0.30 ** | 0.12 |
Junior high school | 0.10 | 0.11 | 0.11 | 0.11 | 0.11 | 0.11 | 0.30 ** | 0.13 |
Primary school and below | −0.15 | 0.11 | −0.13 | 0.11 | −0.12 | 0.11 | 0.20 | 0.13 |
Income level ( Below USD 3000 as reference) | ||||||||
USD 3000–USD 9000 | 0.37 *** | 0.06 | 0.32 *** | 0.06 | 0.32 *** | 0.06 | 0.24 *** | 0.07 |
USD 9000–USD 18,000 | 0.45 *** | 0.07 | 0.36 *** | 0.07 | 0.36 *** | 0.07 | 0.35 *** | 0.10 |
Above USD 18,000 | 0.26 *** | 0.07 | 0.17 ** | 0.07 | 0.17 ** | 0.08 | 0.24 * | 0.12 |
Insurance coverage (Free medical care as reference) | ||||||||
Formal employee program | −0.04 | 0.07 | −0.04 | 0.07 | −0.04 | 0.07 | −0.02 | 0.09 |
Resident program | −0.00 | 0.07 | −0.03 | 0.07 | −0.04 | 0.07 | −0.01 | 0.10 |
Other coverage | 0.32 ** | 0.15 | 0.29 * | 0.15 | 0.28 * | 0.15 | 0.08 | 0.17 |
No coverage | −0.16 ** | 0.08 | −0.21 ** | 0.08 | −0.23 *** | 0.08 | −0.24 ** | 0.11 |
Department (Internal medicine as reference) | ||||||||
Surgery | 0.07 | 0.07 | 0.11 | 0.07 | 0.11 | 0.07 | 0.07 | 0.09 |
Obstetrics and gynecology | 0.10 | 0.06 | 0.03 | 0.06 | 0.03 | 0.06 | −0.12 | 0.09 |
Pediatric | 0.10 | 0.08 | 0.14 * | 0.08 | 0.14 * | 0.08 | 0.07 | 0.13 |
Other departments | 1.11 ** | 0.05 | 1.13 ** | 0.05 | 0.13 ** | 0.05 | 0.12 * | 0.07 |
Type of hospital (General hospital as reference) | ||||||||
MCH hospital | −0.17 *** | 0.06 | −0.17 *** | 0.06 | −0.16 *** | 0.06 | - | - |
TCM hospital | 0.28 *** | 0.05 | 0.29 *** | 0.05 | 0.29 *** | 0.05 | - | - |
Affiliation of hospital (Central affiliation as referene) | ||||||||
Local affiliation | 0.24 *** | 0.08 | 0.24 *** | 0.08 | 0.24 *** | 0.08 | - | - |
Region (Eastern as reference) | ||||||||
Central | 0.00 | 0.06 | −0.00. | 0.06 | −0.02 | 0.07 | - | - |
Western | −0.54 *** | 0.05 | −0.55 *** | 0.05 | −0.55 *** | 0.05 | - | - |
Constant | 1.57 *** | 0.25 | 1.82 *** | 0.25 | 1.80 *** | 0.25 | 2.11 *** | 0.31 |
Number of Observations | Mean | SD | Min | Max | |
---|---|---|---|---|---|
Model 2 (logit DID) | |||||
Interacted policy effect | 21,770 | 0.15 | 0.04 | 0.05 | 0.30 |
SE of the interacted policy effect | 21,770 | 0.01 | 0.002 | 0.01 | 0.03 |
z-statistic of the interacted policy effect | 21,770 | 10.27 | 1.30 | 3.87 | 13.95 |
Model 3 (PSM logit DID) | |||||
Interacted policy effect | 21,570 | 0.15 | 0.04 | 0.05 | 0.30 |
SE of the interacted policy effect | 21,570 | 0.01 | 0.003 | 0.01 | 0.03 |
z-statistic of the interacted policy effect | 21,570 | 10.26 | 1.29 | 3.87 | 13.99 |
Model 4 (PSM logit DID hospital fixed-effect) | |||||
Interacted policy effect | 21,570 | 0.12 | 0.07 | 0.005 | 0.30 |
SE of the interacted policy effect | 21,570 | 0.04 | 0.02 | 0.002 | 0.08 |
z-statistic of the interacted policy effect | 21,570 | 3.00 | 0.27 | 2.02 | 3.83 |
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Cheng, H.; Zhang, Y.; Sun, J.; Liu, Y. How Did Zero-Markup Medicines Policy Change Prescriptions in the Eyes of Patients?—A Retrospective Quasi-Experimental Analysis. Int. J. Environ. Res. Public Health 2022, 19, 12226. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191912226
Cheng H, Zhang Y, Sun J, Liu Y. How Did Zero-Markup Medicines Policy Change Prescriptions in the Eyes of Patients?—A Retrospective Quasi-Experimental Analysis. International Journal of Environmental Research and Public Health. 2022; 19(19):12226. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191912226
Chicago/Turabian StyleCheng, Hanchao, Yuou Zhang, Jing Sun, and Yuanli Liu. 2022. "How Did Zero-Markup Medicines Policy Change Prescriptions in the Eyes of Patients?—A Retrospective Quasi-Experimental Analysis" International Journal of Environmental Research and Public Health 19, no. 19: 12226. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191912226