ArticleInternational journal of health policy and management2025
Effects of Hospital Payment Reform of Government Budget Allocation and Social Health Insurance in a Pilot in China.
Article in International journal of health policy and management, 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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Who cites it
1 citing paper in PubMed.
- From individual burden to social risk pooling: drivers of the declining out-of-pocket health expenditure share in China (2009-2024).International journal for equity in health · 2026Article
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7 authors.
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Abstract
backgroundGovernment budget allocation (GBA) and social health insurance (SHI) constitute the primary revenue sources for public hospitals in China, with GBA accounting for a substantially smaller proportion compared to SHI. Starting in 2015, a megacity in southern China gradually introduced payment reforms. GBA, previously based on government approved number of staff (input-based), was replaced with an output-based model. Subsequently, SHI payment method was changed from fee-for-service (FFS) to case-based payment.
methodsThe study adopted a staggered difference-in-differences (DiD) model to assess the effects of reforms on service volume and capacity, as well as hospital efficiency. We used hospital-level panel data of 29 hospitals in the city from 2009 to 2022.
resultsThe GBA reform increased annual outpatient visits by 301 374 per hospital (
conclusionThe output-based GBA reform increased outpatient service volume and the number of healthcare professionals, while the case-based SHI reform raised inpatient discharges. Only GBA was associated with a modest efficiency gain given the distinct incentives of GBA and SHI. Future research should explore strategies for better alignment of multiple funding streams, such as unified purchasing with blended payment models or clearer functional differentiation.
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