Objective:To examine the impact and mechanisms of the direct settlement of nonlocal medical expenses policy on migrant health and quantify its inter-provincial medical insurance fund flow effects.Methods:Using China Labor-Force Dynamics Survey data and city-level policy implementation data,a staggered difference-in-differences model evaluates the policy's health benefits for migrants.Models based on migrant distribution,medical costs,and reimbursement rates estimate 2023 provincial medical fund changes and forecast future expenditure shares from 2026-2030.Results:The policy increases the likelihood of migrants reporting good health by approximately 4.4%,likely through higher reimbursement rates,increased education spending,and improved social integration.Guizhou and Anhui face the highest migrant-related net expenditure shares.Conclusion:The policy significantly enhances migrant health,with rigid costs ensuring equal rights in destination regions.However,inter-provincial disparities call for a regional balance mechanism to manage fund expenditures in high-quality urbanization.

Objective To analyze the impact of medical insurance payment method reform on the efficiency of health services in China and provide empirical evidence for optimizing payment policies.Methods Using panel data from 31 Chinese provinces from 2012 to 2022,it measured health service efficiency with super-efficiency SBM model,assessed the effects of payment reforms using a staggered DID model,and analyzed the heterogeneous impacts of health informatization levels and health resources.Results DRG payment method reform increased health service efficiency,while no evidence was found that DIP payment method reform improved efficiency.Heterogeneity analysis showed that DRG payment method reform effects were not significantly influenced by health informatization levels or bed resource distribution,where as DIP payment method reform's negative effects were positively moderated in regions with higher informatization or abundant bed resources.Conclusion DRG payment method reform can improve the efficiency of healthcare services.It is recommended to accelerate the promotion of the DRG payment method system.Regarding the reform of the DIP payment system,it is recommended to improve the DIP scoring settlement mechanism,strengthen refined disease management,optimize hospital information system construction,enhance the medical insurance information platform and medical record quality control system,in order to improve hospital management levels and service efficiency.

Objective:To examine the impact and mechanisms of the direct settlement of nonlocal medical expenses policy on migrant health and quantify its inter-provincial medical insurance fund flow effects.Methods:Using China Labor-Force Dynamics Survey data and city-level policy implementation data,a staggered difference-in-differences model evaluates the policy's health benefits for migrants.Models based on migrant distribution,medical costs,and reimbursement rates estimate 2023 provincial medical fund changes and forecast future expenditure shares from 2026-2030.Results:The policy increases the likelihood of migrants reporting good health by approximately 4.4%,likely through higher reimbursement rates,increased education spending,and improved social integration.Guizhou and Anhui face the highest migrant-related net expenditure shares.Conclusion:The policy significantly enhances migrant health,with rigid costs ensuring equal rights in destination regions.However,inter-provincial disparities call for a regional balance mechanism to manage fund expenditures in high-quality urbanization.

Objective To analyze the impact of medical insurance payment method reform on the efficiency of health services in China and provide empirical evidence for optimizing payment policies.Methods Using panel data from 31 Chinese provinces from 2012 to 2022,it measured health service efficiency with super-efficiency SBM model,assessed the effects of payment reforms using a staggered DID model,and analyzed the heterogeneous impacts of health informatization levels and health resources.Results DRG payment method reform increased health service efficiency,while no evidence was found that DIP payment method reform improved efficiency.Heterogeneity analysis showed that DRG payment method reform effects were not significantly influenced by health informatization levels or bed resource distribution,where as DIP payment method reform's negative effects were positively moderated in regions with higher informatization or abundant bed resources.Conclusion DRG payment method reform can improve the efficiency of healthcare services.It is recommended to accelerate the promotion of the DRG payment method system.Regarding the reform of the DIP payment system,it is recommended to improve the DIP scoring settlement mechanism,strengthen refined disease management,optimize hospital information system construction,enhance the medical insurance information platform and medical record quality control system,in order to improve hospital management levels and service efficiency.

Objective To analyze the change of healthcare quality after the Diagnosis-Intervention Packet(DIP)payment system reform and provide evidence for improving payment system reform in China.Methods It collected discharge records of hospitalized patients with employee basic medical insurance scheme in first DIP pilot hospitals of a city from July 2017 to June 2021.It included three death-related measures and two readmission-related mea-sures,which were all risk-adjusted considering the patient mix.It used t test to compare their differences before and after the DIP reform in July 2019.Results After the risk-adjustment,mortality rate of surgical patients,mortality rate of patients in low-risk DIP groups,all-cause readmission rate within 30 days after discharge and readmission rate with the same principal diagnosis within 30 days after discharge declined 0.06 percentage points(P=0.031),0.15 percentage points(P=0.001),0.47 percentage points(P＜0.001)and 0.72 percentage points(P＜0.001),respectively.Conclusion No current evidences indicated negative impacts of the DIP payment reform on the quality of healthcare in the city.Case-based payment pilot cities should closely monitor the change of healthcare quality after the reform.