Health Economics Review最新文献

{"title":"Analysis of the role of medical insurance in the \"Health shocks-consumption upgrading\" model: evidence from China.","authors":"Qi Hu, Ennan Wang, Minglai Zhu","doi":"10.1186/s13561-025-00635-6","DOIUrl":"https://doi.org/10.1186/s13561-025-00635-6","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has brought significant health shocks worldwide, along with a certain burden on healthcare systems. China's healthcare security system has been continuously improved and has essentially achieved universal coverage. Moreover, the health impact of COVID-19 on the Chinese population is diminishing, and the trend of consumption upgrading is becoming more pronounced.</p><p><strong>Methods: </strong>Based on the Ramsey-Cass-Koopmans model, this study constructs a theoretical model of \"health shocks-consumption upgrading\" to deduce the impact of health shocks on consumption upgrading. We examine the results of the theoretical model using provincial panel data from China spanning from 2002 to 2019 and employing the system GMM estimation method. Furthermore, based on a moderation effect model, we explore the mechanism of basic medical insurance systems in this model.</p><p><strong>Results: </strong>The theoretical model deduces that health shocks lead to a decline in consumption upgrading, which is empirically confirmed. Additionally, the results of moderation effect analysis demonstrate that basic medical insurance systems play a positive moderating role in the \"health shocks-consumption upgrading\" model. Among the basic medical insurance systems, the New Rural Cooperative Medical Scheme (NRCMS) primarily acts as a positive moderator.</p><p><strong>Conclusion: </strong>Health shocks lead to consumption downgrading, while basic medical insurance systems help to diversify medical risks, alleviate health shocks, reduce precautionary savings, and thereby promote consumption upgrading.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"37"},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Framing financial incentives to promote hypertension care among rural primary doctors in Shandong Province, China: study protocol of a randomized field trial.","authors":"Yue Zhong, Pengyang Fan, Jialong Tan, Elizabeth Maitland, Stephen Nicholas, Yiwei Qiao, Dejian Kou, Zehua Meng, Jian Wang","doi":"10.1186/s13561-025-00634-7","DOIUrl":"https://doi.org/10.1186/s13561-025-00634-7","url":null,"abstract":"<p><strong>Background: </strong>Managing hypertension in rural China poses significant challenges, as rural physicians often struggle to provide consistent, high-quality care. Insufficient financial incentives may explain the sub-optimal long-term treatment behavior by rural doctors. This study designs a protocol for studying better-framed financial incentives for rural physicians to manage hypertension treatment, specifically the impact of loss-framed versus gain-framed incentives in enhancing hypertension management.</p><p><strong>Methods: </strong>This protocol outlines a three-arm randomized controlled trial to be conducted in rural China. A total of 300 primary doctors, involving 1,500 hypertension patients, will be randomly assigned in a 1:1:1 ratio to two intervention groups or a control group. Financial incentives will be implemented in the two intervention groups, namely gain-framed incentives and loss-framed incentives. The trial will include a six-month intervention period followed by six months of follow-up. Changes in patients' blood pressure (BP) values include both systolic and diastolic BP, hypertension control rates, physicians' hypertension care performance and patient medication adherence will be measured. Data collection includes baseline information and regular blood pressure measurements.</p><p><strong>Discussion: </strong>This study will determine the effectiveness of a 6-month framing financial incentive intervention in improving doctors' hypertension management and patients' blood pressure control outcomes while comparing the different effects of loss framing and gain framing.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry (ChiCTR) ChiCTR2300077733, Date registered: 07/11/2023.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"36"},"PeriodicalIF":2.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three decades in healthcare service efficiency evaluation: a bootstrapping Data Envelopment Analysis (DEA) of Ministry of Health Malaysia.","authors":"M Zulfakhar Zubir, Aizuddin A N, Mohd Rizal Abdul Manaf, A Aziz Harith, M Ihsanuddin Abas, Maizatul Izyami Kayat, M Firdaus M Radi, Mas Norehan Merican, Nurcholisah Fitra, Affendi M Ali, Sharifah Ain Shameera Syed Rusli","doi":"10.1186/s13561-025-00624-9","DOIUrl":"https://doi.org/10.1186/s13561-025-00624-9","url":null,"abstract":"<p><strong>Background: </strong>One of the most important ways to boost the health system's performance and lower the rising cost of healthcare is to increase its efficiency. The objective of this study is to evaluate the efficiency of the MOH in providing public health services and to gauge the progress of health plans in Malaysia.</p><p><strong>Methods: </strong>Three output variables (number of admissions, number of outpatient attendances, and number of maternal and child health attendances) and six input variables (budget allocation, number of doctors, dentists, pharmacists, nurses, and community nurses) were used in a Data Envelopment Analysis (DEA) Window Analysis. Eight input-output models' bias-corrected efficiency scores were obtained using bootstrapping.</p><p><strong>Setting: </strong>Ministry level in public health service.</p><p><strong>Participant: </strong>28 Decision making units (DMUs) from 1995 to 2022.</p><p><strong>Results: </strong>Robust performance over the study period was shown by the mean bias-corrected efficiency score of 0.974 (95% CI: 0.907-0.989) under the Variable Returns to Scale (VRS) model. Lower Constant Returns to Scale (CRS) model scores, on the other hand, draw attention to scale-level inefficiencies. During the COVID-19 pandemic, efficiency decreased due to higher input demands and limited outputs.</p><p><strong>Conclusions: </strong>Although MOH has attained a high level of technological efficiency, expanding operations and resolving inequalities in rural areas remain difficult. Targeted tactics including telemedicine adoption, resource redistribution, and a move towards preventive treatment are advised in order to improve fairness and resilience.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"34"},"PeriodicalIF":2.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of expanding the target population of biennial screening for breast cancer from ages 50-69 to 45 and/or 74: A cohort modelling study in the Finnish setting.","authors":"Filip Siegfrids, Sirpa Heinävaara, Tytti Sarkeala, Laura Niinikoski, Juha Laine","doi":"10.1186/s13561-025-00628-5","DOIUrl":"https://doi.org/10.1186/s13561-025-00628-5","url":null,"abstract":"<p><strong>Background: </strong>Within Finland's breast cancer screening program, all women aged 50-69 are invited to biennial screening. Current European guidelines recommend screening in ages 45-49 and 70-74 conditional upon, inter alia, demonstrated context-specific cost-effectiveness. This study aims to determine the cost-effectiveness of expanding the target population of biennial screening to ages 45 and/or 74, compared to the current national breast cancer screening strategy, in the Finnish setting.</p><p><strong>Methods: </strong>Screening strategies' costs and quality-adjusted life years (QALY), aggregated over a lifetime horizon for the population simulated through a decision-analytic model, allow for comparison through incremental cost-effectiveness ratios. The model, using a Markov cohort simulation approach, was adapted to the cancer stage classification system used by the Finnish Cancer Registry (FCR) and calibrated to observed metrics in the Finnish female population. The analysis was conducted from a limited societal perspective, using a discount rate of 3% for costs and outcomes. Sensitivity analyses were performed to assess decision uncertainty, using an implicit willingness-to-pay (WTP) threshold range of €25 000-50 000 per incremental QALY.</p><p><strong>Results: </strong>Compared to the current national screening strategy, both strategies with a starting age of 45 were cost-effective at the WTP-threshold of €50 000 per incremental QALY. Biennial screening in ages 45-69 was also cost-effective at €25 000 per QALY and demonstrated the highest probability of cost-effectiveness of all screening strategies over the whole WTP-threshold range of €25 000-50 000 per QALY. Biennial screening in ages 50-74 was dominated by all strategies over the threshold range.</p><p><strong>Conclusions: </strong>Expanding the national screening strategy target population age is likely to produce net health benefits to acceptable costs, insofar as women aged 45-49 are covered by the expansion. Only expanding the target population to age 74 is unlikely to be cost-effective, given a WTP-threshold range of €25 000-50 000 per incremental QALY.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"35"},"PeriodicalIF":2.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety, efficacy, and cost-effectiveness evaluation of systemic treatments for refractory colorectal cancer: a systematic review and modeling study.","authors":"Mingye Zhao, Yunlin Jiang, Taihang Shao, Wenxi Tang","doi":"10.1186/s13561-025-00622-x","DOIUrl":"https://doi.org/10.1186/s13561-025-00622-x","url":null,"abstract":"<p><strong>Objectives: </strong>To conduct pooled estimates and comparative evaluations of safety and efficacy, alongside cost-effectiveness and value-based pricing analyses, for systemic treatments recommended by the National Comprehensive Cancer Network in refractory colorectal cancer.</p><p><strong>Methods: </strong>A comprehensive search for related randomized controlled trials was conducted on PubMed, EMBASE, the Cochrane Library, and ClinicalTrials.gov. Safety was evaluated by aggregating treatment-related adverse events (TRAEs) and performing Bayesian network meta-analysis (NMA) for indirect comparisons. Pooled survival estimates of overall survival (OS) and progression-free survival (PFS) were conducted to assess treatment efficacy. For NMA of OS and PFS, time-variant fractional polynomial models were employed as the primary analysis, with Cox proportional hazards models used for result validation. Economic evaluations were performed using partitioned survival models from the US public sector perspective. Clinical parameters were sourced from meta-analyses; cost parameters included drug treatment, follow-up and administration, end-of-life care, and adverse event management expenses, which were obtained from the Federal Supply Schedule, public databases or published literature. Utility values were sourced from the CORRECT trial. Price simulations were also conducted. Robustness of results was confirmed by sensitivity and scenario analyses RESULTS: We included nine studies comprising 3,978 patients and incorporating six treatments recommended by NCCN, including best supportive care (BSC), regorafenib, regorafenib dose optimization (REDo), trifluridine/tipiracil (TAS-102), TAS-102 with bevacizumab (TAS-BEV), and fruquintinib. Targeted treatments increased serious TRAEs and grade 3 + TRAEs compared to BSC. However, no significant safety differences were found among the targeted therapies. Regarding efficacy, REDo led in median OS, while fruquintinib led in median PFS. NMA indicated that TAS-BEV had the greatest PFS and OS survival benefit, followed by fruquintinib and REDo. Cost-effectiveness analysis favored BSC as the least expensive and the most cost-effective profile. TAS-BEV had the greatest effectiveness, with TAS-102 being the most cost-effective among targeted therapies. For cost-effectiveness against BSC, the price reductions of TAS-102, fruquintinib, REDoS, regorafenib, and TAS-BEV were 39%, 24%, 14%, 8%, and 7%, respectively.</p><p><strong>Conclusions: </strong>Targeted therapies have comparable safety; TAS-BEV is highly effective, TAS-102 is the top cost-effective targeted therapy. Treatment choice should balance individual patient needs with safety, efficacy, and cost.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"33"},"PeriodicalIF":2.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness analysis of duodenal-jejunal bypass sleeve device for people with obesity.","authors":"Qian Xu, Wei Yan, Luo Li, Bao Liu","doi":"10.1186/s13561-025-00623-w","DOIUrl":"10.1186/s13561-025-00623-w","url":null,"abstract":"<p><strong>Background: </strong>Obesity has become major public health problem around the world. Lifestyle interventions, Pharmacotherapy and bariatric surgery are the common intervention to reduce weight in clinical practice. This study aims to conduct an economic evaluation of Duodenal-Jejunal Bypass Sleeve (DJBS) plus Intensive Lifestyle Intervention (ILI) compared with ILI only in people with obesity in China.</p><p><strong>Methods: </strong>A hybrid model using a Decision Tree and Markov model was used to compare 9-month and lifetime horizon cost-effectiveness between DJBS plus ILI and ILI only. The data on clinical effectiveness were based on a prospective, open-label, and randomized trial (NCT05938231). This study employed 1-3 times the Gross Domestic Product (GDP) per capita (¥85,498, exchange rate: $1 US dollar = ¥6.73, 2022) and disposable income per capita (¥36,883, 2022) as the Willingness-To-Pay (WTP) thresholds. One-way, probabilistic sensitivity and scenario analysis were performed to test the robustness of the results.</p><p><strong>Results: </strong>The results of the 9-month decision tree model showed that compared to ILI only, DJBS plus ILI decreased body mass index (BMI) by 1.69 kg/m2 (1.41 vs. 3.10), with an increasing cost of ¥28,963.98 yuan (¥29,111.06 vs.¥147.08). The incremental cost-effectiveness ratio (ICER) was ¥17,138.45 per unit decrease of BMI. The lifetime horizon model showed that compared to ILI only, DJBS plus ILI had a higher cost of ¥13261.94 yuan (¥31,688.98 vs. ¥18,427.04), while with a life-year increase of 0.02 (9.43 vs. 9.41) and quality-adjusted life years (QALYs) increase of 0.15 (7.82 vs. 7.67) per people with obesity. The ICER was ¥88,412.93 per QALY gained. Probability sensitivity analysis showed the robustness of the economic evaluation results.</p><p><strong>Conclusion: </strong>The findings suggested that DJBS plus ILI was not a cost-effective strategy over a lifetime horizon when the WTP threshold was set at GDP per capita and disposable income per capita. However, it was considered cost-effective when the threshold was set at 1.03 times GDP per capita.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"32"},"PeriodicalIF":2.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health insurance premium in Colombia for 2025: a strictly political-ideological decision without technical-scientific arguments?","authors":"Oscar Espinosa, Paul Rodríguez-Lesmes, Sergio Prada, Mery Bolívar, Juan Diego Mejía-Becerra, Andrés I Vecino-Ortíz","doi":"10.1186/s13561-025-00620-z","DOIUrl":"10.1186/s13561-025-00620-z","url":null,"abstract":"<p><p>The Colombian Ministry of Health's decision to increase the health insurance premium (Capitation Payment Unit) by 5.36% for 2025, close to the inflation rate, has sparked controversy. This adjustment disregards factors that contribute to rising healthcare costs, leading to concerns over the guarantee the right to health for Colombians and financial sustainability of the health system. The insufficient increase raises the likelihood of surpassing premium coverage, as evidenced by recent actuarial studies. This decision could affect the quality of services and jeopardize the health of 50 million inhabitants in the Colombian territory. The paper calls for a more robust, technical approach to ensure the financial stability and quality of care in the Colombian health system.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"31"},"PeriodicalIF":2.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building an integrated healthcare system of China: an assessment of coupling coordination between disease prevention, medical services, and healthcare financing from 2012 to 2021.","authors":"Guowu Huang, Wanying Wu, Qiaoxi Wen, Liyong Lu, Jay Pan","doi":"10.1186/s13561-025-00616-9","DOIUrl":"10.1186/s13561-025-00616-9","url":null,"abstract":"<p><strong>Background: </strong>Universal Health Coverage (UHC) is a central component of the Sustainable Development Goals, and integrated healthcare is recognized as a key pathway to achieving UHC. China's healthcare reform, aimed at realizing the \"Healthy China 2035\" goal, faces challenges in ensuring the coordinated development of disease prevention, medical services, and healthcare financing. However, empirical research assessing the integration of these three systems in China is scarce.</p><p><strong>Purpose: </strong>This study aims to assess the coupling and coordination between disease prevention, medical services, and healthcare financing in China from 2012 to 2021, with the goal of providing a comprehensive evaluation of the progress made in building an integrated healthcare system.</p><p><strong>Methods: </strong>The study employs the Entropy Weight Method (EWM) to determine the weight of each system index, followed by the Coupling Coordination Degree Model (CCDM) to measure the coordination among the three components. The Grey Correlation Analysis (GCA) is used to identify key driving factors, and the Grey Prediction Model (GM (1.1)) is applied to forecast future trends of integrated healthcare development across Chinese provinces.</p><p><strong>Results: </strong>The coupling coordination degree of the three systems ranged from 0.12 to 0.73 from 2012 to 2021, reflecting a shift from moderate imbalance to mild imbalance over time. Regional disparities were observed, with eastern provinces showing higher levels of integration than western provinces. The disease prevention subsystem emerged as the primary constraint to the overall integration process. Most regions exhibited a consistent upward trend in the coupling coordination index, though development speeds varied significantly across provinces.</p><p><strong>Conclusion: </strong>While China's integrated healthcare system has shown progress, there is still considerable room for improvement. Strengthening disease prevention efforts is critical to enhancing the overall coordination of the healthcare system. This study provides valuable insights for other developing countries facing similar challenges in healthcare integration.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"30"},"PeriodicalIF":2.7,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of political and religious affiliation in explaining county-level COVID-19 Vaccine Hesitancy.","authors":"Declan R Carroll, Stephen J Conroy, Adriana Vamosiu","doi":"10.1186/s13561-025-00605-y","DOIUrl":"10.1186/s13561-025-00605-y","url":null,"abstract":"<p><p>The authors use county-level data to test whether an array of socioeconomic, demographic, political and religious variables explain COVID-19 vaccination rates. Results presented here build upon previous investigations of COVID-19 vaccine hesitancy in different contexts and are largely consistent with those findings. Background controls such as county's percent male (+), median age (+), percent White (-), median household income (+), percent self-employed (-), and the percent with a college or higher education (+) explain county-level vaccination rates for COVID-19. Political affiliation (Percent Republican (-)) remains the strongest predictor in terms of overall statistical significance. The county's percent Catholic (+) and percent Evangelical (-) are also very strong predictors, though in opposite directions. This analysis includes state-level fixed effects and several robustness checks.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"29"},"PeriodicalIF":2.7,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of the diagnosis-intervention packet reform on costs and healthcare resource utilization: evidence from Guangzhou, China.","authors":"Bingxue Fang, Yawen Jiang","doi":"10.1186/s13561-025-00615-w","DOIUrl":"10.1186/s13561-025-00615-w","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis-intervention packet (DIP) payment reform, utilizing big data for patient classification and payment standardization, was initially developed and piloted in China. Guangzhou, the pilot mega-city, rolled out DIP payment reform in 2018 to regulate medical expenditures. We estimated the impacts of DIP on costs and healthcare resource utilization in Guangzhou using a nine-year panel data set of Guangzhou and other regions between 2018 and 2020.</p><p><strong>Methods: </strong>By employing the synthetic difference-in-difference (SDID) method, we captured changes in outcome variables before and after DIP implementation in Guangzhou and non-reforming regions.</p><p><strong>Results: </strong>DIP payment reform increased per-episode inpatient costs by CNY 1574.735 (95% CI: 148.330 to 3001.140, P < 0.05), CNY 1583.413 (95% CI: 247.356 to 2919.470, P < 0.05), and CNY 1448.065 (95% CI: -132.051 to 3028.181.140, P < 0.1) among all hospitals, public hospitals, and private hospitals, respectively. In contrast, DIP had little effect on the average length of stay (LOS) among all hospitals from 2018 to 2020. Although DIP did not impact in-hospital mortality (IHM) overall, it increased IHM by 0.330 percentage points (95% CI: 0.008 to 0.652, P < 0.05) and 0.311 percentage points (95% CI: 0.158 to 0.463, P < 0.01) among private hospitals and secondary hospitals.</p><p><strong>Conclusions: </strong>Our results suggest that the effects of DIP payment reform were mixed. While it did increase healthcare costs, its impacts on quality and operation efficiency varied significantly across different types of hospitals.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"28"},"PeriodicalIF":2.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}