How a Chinese City Rewired Hospital Payments to Push Care Back to the

A new study in the International Journal for Equity in Health examines how a Chinese city, Sanming in Fujian province, changed hospital payment incentives to shift care back toward primary services. Led by Zhe Liu of Fudan University and Tongji Medical College with collaborators including Nankai University and Union Hospital, the analysis uses 12 years of monthly data from January 2013 to December 2024. Researchers apply interrupted time-series analysis, modeling changes after three policy interruptions in August 2015, January 2018, and October 2021. Their findings offer a cautiously qualified “yes”: reforms moved care toward primary care and altered hospitals’ internal revenue composition. The team stress-tested results across alternative modeling choices to check robustness.