ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1530176
The Impact of Bundled Payment on the Economic Burden and Satisfaction of Patients in Close-knit County Medical Community in China
Provisionally accepted
- 1School of Public Health, Youjiang Medical University for Nationalities, Guangxi, China
- 2China National Health Development Research Center, Beijing, Beijing Municipality, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: China is setting up a close-knit County Medical Community (CCMC) to connect county hospitals, township health centers, and village clinics. The medical insurance agency will count the number of insured people in the CCMC area and distribute funds to the community as a whole. Then, the county hospital will work with local health facilities to decide how to use these funds. This reform aims to improve primary healthcare services, lower medical costs, support residents' health, and boost their satisfaction with healthcare.This study looked at data from counties in China monitored by County Medical Communities from 2018 to 2022. We used difference-in-differences (DID) to analyze how bundled payments affected patients' financial burdens, the income of healthcare providers and the satisfaction of patients and healthcare providers.The bundled payment policy had no significant effect on the average cost per discharged patient (P > 0.05). In 2022, the average outpatient expenses increased by 17.58 yuan (P < 0.05), while in 2021, the actual reimbursement rates for hospitalization costs rose by 2.18% (P < 0.05). The policy also significantly increased the per-capita income of providers in county hospitals and primary care institutions in 2021 (P < 0.01); however, we cannot quantitatively isolate the precise marginal contribution of the bundled payment policy to the observed income increases Additionally, it had no significant impact on the satisfaction levels of either patients or healthcare providers (P > 0.05).Bundled medical insurance payments in the CCMC do not add financial stress for patients and help low-income families. They also boost the income of healthcare providers . However, there is still a need for improvements to enhance overall satisfaction with the healthcare system.
Keywords: Medical Insurance Bundled Payment, Close-knit County Medical community, economic burden, Satisfaction, Economic incentive
Received: 28 Nov 2024; Accepted: 14 Apr 2025.
Copyright: © 2025 GUO, Qian, Li, Wang, Zhu, Huang, ZHANG and Nong. 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: Sheng Nong, School of Public Health, Youjiang Medical University for Nationalities, Guangxi, 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.