Bridging care hierarchies through regional global budget payment: evidence from county medical communities in Zhejiang Province, China.

ABSTRACT: A hierarchical medical system anchored in primary healthcare is a critical mechanism for global healthcare systems to alleviate financing pressures and enhance health outcomes. Leveraging panel data from Zhejiang Province (2017-2022), this study evaluates how regional global budget payment reforms, implemented within county medical communities, influence the progression of the hierarchical medical system. The reforms were associated with a 3.0% (90% CI: -6.3 to 0.3, P < 0.1) reduction in patient volumes at county-level hospitals and a 30.2% (95% CI: 3.1-57.4, P < 0.05) surge in downward referrals to primary institutions. Concurrently, primary facilities saw an 8.3% (95% CI: 0.56-16.0, P < 0.05) increase in outpatient visits and 6.9% (95% CI: 0.15-13.7, P < 0.05) revenue growth. From the pe

SUBMITTER: Liu X 

PROVIDER: S-EPMC12448831 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature