Risk Governance of Payment Exceptions Under China’s DRG/DIP Reform: A Structured Policy-Text Analysis of Special Case Negotiation Rules

Description

Kedi Sun reads China's hospital payment reform rules to judge how well they govern special case talks, in a 2026 journal article. Under the new case based payment, odd cases that fit no set price may be pled one by one. That door can leak funds, invite favor, and stall care if rules are soft.

Sun scored twenty texts in one province's chain, from the national rule down to all its city rules. Two coders marked thirty rule points across five risk fields on a three step scale. Scores ran high for curbing price misfit, favor, and delay. They ran low for duty and fairness, the field that holds appeals and time caps. Gaps sat in cross area fund duty and plea routes. The author urges tighter text where the chain is weak.

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Source: https://europepmc.org/articles/PMC13549295