This study draws on embedding theory and incentive mechanism theory to construct a multi-dimensional framework for analyzing the integration of county-level health insurance into primary healthcare.Using Qianjiang District,Chongqing,as a case study,it analyses how horizontally bundled funding and service transformation embed insurance into local health governance.The study finds that health insurance is embedded into primary governance through a systemic process driven by values,shaped by social structures,and supported by institutions,involving the reconfiguration of resources,relationships,and interests.Establishing primary care groups as budget units improves alignment between payment and service needs;linking budget limits,surplus incentives,and performance feedback strengthens provider motivation;and coordinated inter-agency mechanisms facilitate integration of fund management and service delivery.

This study draws on embedding theory and incentive mechanism theory to construct a multi-dimensional framework for analyzing the integration of county-level health insurance into primary healthcare.Using Qianjiang District,Chongqing,as a case study,it analyses how horizontally bundled funding and service transformation embed insurance into local health governance.The study finds that health insurance is embedded into primary governance through a systemic process driven by values,shaped by social structures,and supported by institutions,involving the reconfiguration of resources,relationships,and interests.Establishing primary care groups as budget units improves alignment between payment and service needs;linking budget limits,surplus incentives,and performance feedback strengthens provider motivation;and coordinated inter-agency mechanisms facilitate integration of fund management and service delivery.

According to clinical manifestations, 122 cases of subacute and chronic severe viral hepatitis confirmed by pathologic examination, were divided into two types. The severe jaundice-ascites(SJ-A) type accounted for 93 cases (76.2%) and the subfulminant hepatic failure (SFHF) type 29 cases (23.8%), with a ratio of 3.2 : 1. For SFHF type, hepatic encephalopathy was the first prominent feature and ascites might or might not appeared later. Therefore, this type was most easily misdiagnosed as fulminant hepatitis. In comparison with SJ-A type, the average elevation of serum bilirubin was lower and the average depression of prothrombin activivty more remarkable in SFHF type, suggesting that the degree of hepatic necrosis was more severer and the progress to hepatic failure more rapid. The mortality of SFHF type (93.1%) was markedly higher than that of SJ A type (62.4%) (x2 = 7.488, P