Payment mechanism and medical quality: new evidence from China healthcare reform
Yaxuan Zuo, Yingtan Mu, Jiali Zhang, Qiuming Hu · 2026
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Description
Zuo and co-authors examined China's hospital payment reform in 2026, asking whether the way insurers pay shapes the quality of care. Under the DRG and DIP systems, insurers pay a set amount per case type, and the payment differential is the gap between that amount and what care actually cost. The team built a game model of hospitals, patients, and insurers, then tested it with settlement data from pilot cities in 2021 and 2022, using readmission rates as the quality signal.
Cases where payment fell short of costs, a negative differential, came with higher readmission rates and lower measured quality in the settlement data analyzed. The authors suggest that squeezed payments push hospitals toward harder cost control, such as shorter stays and leaner services, which can send patients back sooner. The link varied by surgery type, hospital tier, and patient age, so they urge closer alignment between prices and payment standards.
Catalog record
| CREATOR | Yaxuan Zuo, Yingtan Mu, Jiali Zhang, Qiuming Hu |
|---|---|
| YEAR | 2026 |
| COLLECTION | PAPERS |
| FORMAT | TXT |
| FILE SIZE | 57 KB |
| VERSION | 1.0 |
| LICENSE | CC BY 4.0 |
| RIGHTS | CC BY |
| SOURCE | Europe PMC |