Evidence map›Paper›PMID 40346503›Full record

ArticleBMC public health2025

Does capitation payment influence healthcare service behavior in county medical community? Evidence from patients with diabetes in rural China.

Jiani Zhang, Jincao Yan, Yunke Shi, Xingxing Li, Youqing Xin, Ning Zhang

Abstract read
In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jiani ZhangSchool of Public Health, Capital Medical University, Beijing, 100069, P.R. China.
Jincao YanChuiyangliu Hospital affiliated to Tsinghua University, Beijing, 100022, P.R. China.
Yunke ShiSchool of Public Health, Capital Medical University, Beijing, 100069, P.R. China.
Xingxing LiSchool of Public Health, Capital Medical University, Beijing, 100069, P.R. China.
Youqing XinSchool of Public Health, Capital Medical University, Beijing, 100069, P.R. China. yyyyglyjs0@163.com.
Ning ZhangSchool of Public Health, Capital Medical University, Beijing, 100069, P.R. China. zhangning@ccmu.edu.cn.ORCID http://orcid.org/0009-0006-4707-9280

Funding

National Natural Science Foundation of China 7207041042
6 · The paper itself

Abstract

objectiveAmid efforts to develop primary healthcare, China has been working to establish an integrated care system through the county medical community model, incorporating capitation payment to improve chronic disease management. This study investigates the impact of capitation payment reform on diabetes-related healthcare service behaviors across different levels of healthcare facilities within the county medical community.

methodsWe conducted interrupted time series analysis to evaluate the changes in healthcare service behavior before and after the implementation of the capitation model. Using F County, as the sample area, we collected outpatient reimbursement records of type 2 diabetes mellitus (T2DM) patients from six townships that initiated reform in April 2015. The dataset, covering January 2014 to December 2019, includes 49,326 records from primary healthcare facilities and 1,628 from county hospitals, with information on medical costs, service items, and other details.

resultsFollowing the implementation of capitation, both the average medical costs per visit and proportion of examination and testing costs showed a deceleration in growth in primary healthcare facilities (-0.615, p < 0.05; -1.554, p < 0.01). The proportion of medication costs, the proportion of insulin or combination therapy and the average number of medications exhibited a significant downward trend prior to the reform, while all reversed to upward trends after reform. In county hospitals, the proportion of medication costs increased by 19.115% immediately post-reform, and both the level and slope of average number of medications significantly rose (2.041, p < 0.01; 0.244, p < 0.01). Although the proportion of examination and testing costs increased before the reform, both the instantaneous level and the trend declined afterward (-19.684, p < 0.05; -1.833, p < 0.05).

conclusionsIn the sample area, the average medical costs for T2DM outpatients were effectively controlled after the capitation reform. Township health centers showed improved standardization in prescribing practices, while county hospitals focused more on comprehensive examinations and testing services. Medication prescription intensity increased across all facilities, contributing to enhanced chronic disease management.

Indexed as

Capitation FeeDiabetes Mellitus, Type 2Primary Health CareRural PopulationAgedChinaFemaleHealth Care ReformHumansInterrupted Time Series AnalysisMaleMiddle AgedCapitationCounty medical communityHealthcare service behaviorInterrupted time seriesType 2 diabetes mellitus

Identifiers

PMID40346503
PMCPMC12063278

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.