OBJECTIVES: Soaring medical expense has been a global issue for a decade, and China is confronted with an even greater burden. Increasing medical expense brings great economic burden for patients. From 2009, Global budget payment system (GBPS) was introduced in Shanghai for public hospitals instead of fee-for-service (FFS) payment system to curtail medical expense, and fully implement from 2011. The aim of this paper is analysis to evaluate impact of GBPS in medical expense per capita of inpatients of respiratory disease in Shanghai.

METHODS: Daily number of hospitalizations and medical expense of respiratory disease of residents participated in Urban Employee’s Basic Medical Insurance (UEBMI) in Shanghai from April 1, 2009 to March 31, 2012 was collected by Shanghai Health Insurance Bureau (SHIB). An interrupted time-series analysis (ITS) was used to evaluate the impact of GBPS pilot extended from 2010 and fully implement from 2011 compared to baseline in medical expense.

RESULTS: A Segmented autoregressive integrated moving average (ARIMA) was used to evaluate model medical expense per capita. Our study showed GBPS could retard the monthly increasing speed of medical expense per capita. The monthly increment of total medical expense, medical insurance coverage service expense and self-paying service expense per capita were decreased by CNY 0.08 thousand, 0.07 thousand and 0.01 thousand in 2010 and CNY 0.07 thousand, 0.05 thousand and 0.02 thousand in 2011. But the instant effect of CBPS showed no significant association.

CONCLUSIONS: This study demonstrated the effect of controlling personal medical expense of GBPS, both in medical insurance coverage service expense per capita and self-paying service expense per capita. Study also provided supports that GBPS could slow down the monthly increasing speed of medical expense per capita.