Impact of capitation payment on vascular complications among treated diabetic patients in China

Abstract

Diabetes imposes a substantial economic burden on patients worldwide, and various national healthcare insurance systems adopt different payment methods to mitigate medical costs. However, the impact of insurance payment methods on patient health remains unclear. This study uses the reform of per capita payment for diabetes in Tianjin, China, as a quasi-experiment to investigate the effects of insurance payment methods on diabetes complications. The results indicate that the experimental group exhibited a significant reduction in vascular complications compared to the control group. The incidence of peripheral neuropathy, peripheral vascular disease, diabetic nephropathy, retinopathy, cardiovascular disease, and diabetic foot decreased significantly, with these effects becoming more pronounced over time. Moreover, compared to the control group, the incidence rates of complications in retired individuals were lower than those in employees within the experimental group.