ArticleBMC health services research2025
Impact of per diem payment on medical expenditure, service efficiency, and quality of care for patients with mental disorders: an interrupted time series study.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- Development and validation of dual-time-window readmission prediction models under China's medical insurance multi-payment reform.Frontiers in public health · 2026Article
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2 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe high cost of hospitalization for people with mental disorders can push them into poverty, thereby exacerbating health inequities. While per diem payment (PDP) reforms aim to address this issue, there is limited evidence on the effects of PDP reform in China. This study evaluates the effects of PDP implementation on hospitalization burden, service efficiency, and care quality for patients with mental disorders.
methodsInterrupted time series analysis (ITSA) was used to evaluate the impact of PDP reform on hospitalization burden, service efficiency, and care quality of hospitalization in primary and secondary hospitals. Policy implementation in January 2022 served as the intervention time point. All data were obtained from the City W Medical Insurance Bureau, China.
resultsAfter the PDP reform, the average cost per hospitalization (primary hospitals: β3 = -0.044, P < 0.001; secondary hospitals: β3 = -0.021, P < 0.021), the average out-of-pocket (OOP) per hospitalization (primary hospitals: β3 = -0.034, P < 0.001; secondary hospitals: β3 = -0.042, P < 0.001) and the average basic medical insurance (BMI) reimbursement per hospitalization (primary hospitals: β3 = -0.045, P < 0.001; secondary hospitals: β3 = -0.020, P = 0.037) of people with mental health conditions in primary and secondary hospitals all showed a downward trend. Before the PDP reform, the average length of stay (ALOS) in secondary hospitals showed an upward trend (β1 = 1.384, P = 0.002). The 30-day all-cause admission rate of patients with mental disorders in primary and secondary hospitals showed a downward trend after the reform (primary hospitals: β3 = -0.029, P = 0.009; secondary hospitals: β3 = -0.018, P = 0.008).
conclusionThe PDP reform effectively reduced the financial burdens and improved equitable healthcare access for patients with mental disorders. While enhancing service efficiency and resource allocation, policymakers should monitor potential unintended consequences including insurance fund underutilization and ensure sustained care quality.
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