University Health Services, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, Kumasi, Ghana.
Department of Health Policy, Management and Economics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Ghana Med J. 2022 Sep;56(3):185-190. doi: 10.4314/gmj.v56i3.8.
The study estimated the capitation policy's effect on the under-5 mortality (U5MR) rate in hospitals in Ashanti Region.
We used an interrupted time series design to estimate the impact from secondary data obtained from the DHIMS-2 database. Monthly under-5 deaths and the number of live births per month were extracted and entered into Stata 15.0 for analyses. The U5MR was calculated by dividing the number of live deaths by the number of live births for each of the 60 months of the study.
Health facilities of the Ashanti Region with Data in the DHIMS 2.
the level and trend of U5MR for 31 months during the Capitation Policy implementation (January 2015 to July 2017) were compared with the level and trend 29 months after the withdrawal of the capitation policy (August 2017 to December 2019).
changes in trend or level of U5MR after the withdrawal of capitation.
During the capitation policy, monthly U5MR averaged 10.71 +/-2.71 per 1000 live births. It declined to 0.03 deaths per 1000 live births (p=0.65). After the policy withdrawal, the immediate (increase of 0.01 per 1000live births) and the trend (decline of 0.13 deaths per 1000 live births per month) were still not statistically significant.
We conclude that the capitation policy did not appear to have influenced under-5 mortality in the Ashanti Region. The design of future healthcare payment models should target quality improvement to reduce under-5 mortalities.
None declared.
本研究旨在评估人头付费政策对阿散蒂地区医院 5 岁以下儿童死亡率（U5MR）的影响。
我们使用中断时间序列设计，从 DHIMS-2 数据库中获取二次数据来估计影响。每月 5 岁以下儿童死亡人数和每月活产人数均从数据库中提取并输入到 Stata15.0 进行分析。U5MR 是通过将每个研究 60 个月内的活产死亡人数除以活产人数计算得出的。
阿散蒂地区的卫生机构，DHIMS2 中有数据。
在人头付费政策实施的 31 个月期间（2015 年 1 月至 2017 年 7 月），将 U5MR 的水平和趋势与该政策取消后的 29 个月（2017 年 8 月至 2019 年 12 月）进行比较。
取消人头付费政策后 U5MR 趋势或水平的变化。
在人头付费政策期间，每月 U5MR 平均为每 1000 例活产 10.71 +/-2.71。它下降到每 1000 例活产 0.03 例死亡（p=0.65）。政策取消后，立即（每 1000 例活产增加 0.01）和趋势（每月每 1000 例活产下降 0.13 例死亡）仍无统计学意义。
我们得出结论，人头付费政策似乎并未对阿散蒂地区的 5 岁以下儿童死亡率产生影响。未来医疗保健支付模式的设计应针对质量改进，以降低 5 岁以下儿童死亡率。
无。
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