Does global capitation prospective payment promote integrated delivery networks? Evidence from China's compact county medical communities.

IF 4.5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

International Journal for Equity in Health Pub Date : 2025-06-05 DOI:10.1186/s12939-025-02490-7

Longyan Cui, Gang Yin, Gao Lan Xin Dai, Hongbing Tao

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引用次数: 0

Abstract

Background: Compact county medical communities (CCMCs) have emerged as a key strategy to strengthen primary healthcare delivery in China. The objective of this study was to assess the impact of the global capitation prospective payment (GCP) reform on CCMCs performance.

Methods: This research collected data from 2018 to 2022 across three pilot regions in China. Using interrupted time series analysis (ITSA), we assessed how the implementation of GCP affected CCMCs development.

Results: The ITSA results show that the average length of stay at the lead hospital decreased by 0.105 days (P < 0.001) after the reform in pilot A, while the average hospital cost increased by 62.272 yuan per month (P < 0.05). The lead hospital in Pilot B had a decrease in average inpatient costs of 54.203 yuan per month (P < 0.001). Conversely, Pilot C's the lead hospital had an increase in average inpatient costs of 26.610 yuan per month (P < 0.001), and the average length of stay at the lead hospital increased by 0.028 days (P < 0.05).

Conclusion: GCP has reasonably promoted the benign development of CMCCs. However, the diversity of strategies and operations has resulted in a different focus on effectiveness. Based on local resource endowments, future reforms should pay more attention to the synchronization of payment reforms and organizational changes.

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全球资本化前瞻性支付是否促进了综合配送网络？来自中国县域医疗社区的证据。

背景：紧凑型县医疗社区（CCMCs）已成为中国加强初级卫生保健服务的关键战略。本研究的目的是评估全球资本化预期支付（GCP）改革对ccmc绩效的影响。方法：本研究收集了2018 - 2022年中国三个试点地区的数据。使用中断时间序列分析（ITSA），我们评估了GCP的实施如何影响ccmc的发展。结果：ITSA结果显示，在主导医院的平均住院时间缩短了0.105天(P)。结论：GCP合理地促进了cccc的良性发展。然而，战略和行动的多样性导致了对有效性的不同侧重。基于地方资源禀赋，未来的改革应更加注重支付改革与组织变革的同步。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal for Equity in Health Medicine-Health Policy

CiteScore

7.80

自引率

4.20%

发文量

162

审稿时长

28 weeks

期刊介绍： International Journal for Equity in Health is an Open Access, peer-reviewed, online journal presenting evidence relevant to the search for, and attainment of, equity in health across and within countries. International Journal for Equity in Health aims to improve the understanding of issues that influence the health of populations. This includes the discussion of political, policy-related, economic, social and health services-related influences, particularly with regard to systematic differences in distributions of one or more aspects of health in population groups defined demographically, geographically, or socially.