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REVIEW article

Front. Public Health
Sec. Public Health Policy
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1517502
This article is part of the Research Topic Hospital Management and Healthcare Policy: Financing, Resourcing and Accessibility, Volume II View all 20 articles

The impact of medical insurance payment reform on the provision of basic medical services

Provisionally accepted
Zekun Chen Zekun Chen 1,2*Ying Zhu Ying Zhu 3*Wenbo Liu Wenbo Liu 1*
  • 1 Weifang People's Hospital, Weifang, Shandong Province, China
  • 2 Shandong Second Medical University, Weifang, Shandong Province, China
  • 3 School of Public Health and Management, Weifang Medical University, Weifang, China

The final, formatted version of the article will be published soon.

    Medical insurance payments play a vital role in using public resources wisely to support low-income groups basic medical services and promote social equity. At the same time, the evolution of healthcare insurance payment models will profoundly influence the transformation of hospital service delivery. As global healthcare reforms advance,However, with the advancement of global healthcare reform, hospitals are confronted with the challenge of shifting from traditional patient-centered approaches to value-driven service models. Designing more efficient payment models to reshape hospital service behaviors and quality within the constraints of a limited healthcare budget, ensuring the medical needs of the low-income population are met while maintaining high standards of service efficiency and quality, and returning to(ultimately achieving) a patient-centered care model, is a critical issue that requires our immediate research attention.Many countries worldwide have gained valuable experience in this area. Distilling and summarizing these invaluable experiences will offer us insights for the design of our upcoming health insurance payment models.This review examines the historical progression of healthcare payment systems and their implications for hospital service model transformation. It analyzes the characteristics of various payment models and their effects on hospital operational efficiency, patient experience, allocation and optimization of medical resources and the quality of care provided. Additionally, this paper discusses potential future trends and adaptation strategies for these evolving payment mechanisms, hoping to be of assistance in the future design of health insurance.

    Keywords: medical insurance payment method, hospital service model, Value-driven, Healthcare reform, patient experience, social equity

    Received: 26 Oct 2024; Accepted: 06 Dec 2024.

    Copyright: © 2024 Chen, Zhu and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Zekun Chen, Weifang People's Hospital, Weifang, 261000, Shandong Province, China
    Ying Zhu, School of Public Health and Management, Weifang Medical University, Weifang, China
    Wenbo Liu, Weifang People's Hospital, Weifang, 261000, Shandong Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.