{"title":"基于政策建模一致性(PMC)指数模型的新医保支付政策定量评价","authors":"Chengxin Fan, Xiaochun Li, Jiahui Liu, Yifan Wang, Mengjiao Yang, Wenqiang Yin","doi":"10.1186/s12913-025-13380-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Establishing an efficient health insurance payment mechanism is a core objective of China's healthcare reform. The Chinese government has introduced numerous policy documents to refine the health insurance payment system. However, research on these new payment methods primarily relies on economic analysis such as cost-effectiveness and econometric studies, and has not systematically assessed the internal design and consistency of policy texts.</p><p><strong>Methods: </strong>This study uses text mining methods and the Policy Modeling Consistency (PMC) Index model to construct a policy evaluation framework, which includes 9 primary variables and 39 secondary variables. The framework is used to conduct a quantitative evaluation of China's new health insurance payment policies.</p><p><strong>Results: </strong>The themes of China's new Health insurance payment policies are focused and continuously refined. Quantitative results from the PMC Index model show that the overall policy design is reasonable, although significant differences exist among them. Of the 9 policies, 1 is rated excellent, 4 are rated good, and 4 are rated acceptable.</p><p><strong>Conclusions: </strong>The overall evaluation of health insurance payment policies is positive, though there is room for optimization between individual policies. Strengthening top-level design, improving policy effectiveness, timeliness, and the use of policy tools, as well as promoting localized and standardized reforms, are crucial to fostering high-quality development in healthcare.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1255"},"PeriodicalIF":3.0000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482184/pdf/","citationCount":"0","resultStr":"{\"title\":\"Quantitative evaluation of China's new health insurance payment policy based on the policy modeling consistency (PMC) index model.\",\"authors\":\"Chengxin Fan, Xiaochun Li, Jiahui Liu, Yifan Wang, Mengjiao Yang, Wenqiang Yin\",\"doi\":\"10.1186/s12913-025-13380-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Establishing an efficient health insurance payment mechanism is a core objective of China's healthcare reform. The Chinese government has introduced numerous policy documents to refine the health insurance payment system. However, research on these new payment methods primarily relies on economic analysis such as cost-effectiveness and econometric studies, and has not systematically assessed the internal design and consistency of policy texts.</p><p><strong>Methods: </strong>This study uses text mining methods and the Policy Modeling Consistency (PMC) Index model to construct a policy evaluation framework, which includes 9 primary variables and 39 secondary variables. The framework is used to conduct a quantitative evaluation of China's new health insurance payment policies.</p><p><strong>Results: </strong>The themes of China's new Health insurance payment policies are focused and continuously refined. Quantitative results from the PMC Index model show that the overall policy design is reasonable, although significant differences exist among them. Of the 9 policies, 1 is rated excellent, 4 are rated good, and 4 are rated acceptable.</p><p><strong>Conclusions: </strong>The overall evaluation of health insurance payment policies is positive, though there is room for optimization between individual policies. Strengthening top-level design, improving policy effectiveness, timeliness, and the use of policy tools, as well as promoting localized and standardized reforms, are crucial to fostering high-quality development in healthcare.</p>\",\"PeriodicalId\":9012,\"journal\":{\"name\":\"BMC Health Services Research\",\"volume\":\"25 1\",\"pages\":\"1255\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-09-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482184/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Health Services Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12913-025-13380-7\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Health Services Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12913-025-13380-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Quantitative evaluation of China's new health insurance payment policy based on the policy modeling consistency (PMC) index model.
Background: Establishing an efficient health insurance payment mechanism is a core objective of China's healthcare reform. The Chinese government has introduced numerous policy documents to refine the health insurance payment system. However, research on these new payment methods primarily relies on economic analysis such as cost-effectiveness and econometric studies, and has not systematically assessed the internal design and consistency of policy texts.
Methods: This study uses text mining methods and the Policy Modeling Consistency (PMC) Index model to construct a policy evaluation framework, which includes 9 primary variables and 39 secondary variables. The framework is used to conduct a quantitative evaluation of China's new health insurance payment policies.
Results: The themes of China's new Health insurance payment policies are focused and continuously refined. Quantitative results from the PMC Index model show that the overall policy design is reasonable, although significant differences exist among them. Of the 9 policies, 1 is rated excellent, 4 are rated good, and 4 are rated acceptable.
Conclusions: The overall evaluation of health insurance payment policies is positive, though there is room for optimization between individual policies. Strengthening top-level design, improving policy effectiveness, timeliness, and the use of policy tools, as well as promoting localized and standardized reforms, are crucial to fostering high-quality development in healthcare.
期刊介绍:
BMC Health Services Research is an open access, peer-reviewed journal that considers articles on all aspects of health services research, including delivery of care, management of health services, assessment of healthcare needs, measurement of outcomes, allocation of healthcare resources, evaluation of different health markets and health services organizations, international comparative analysis of health systems, health economics and the impact of health policies and regulations.