How do tensions between medical professionalism and financial incentives play out under case-based payment reform in China

Abstract

To address rapidly increasing healthcare expenditures of social health insurance, the Chinese government has recently introduced a provider payment reform. While some studies have examined the payment reform effects, findings are mixed, and the deeper mechanisms of how these changes influence physicians’ behaviours remain unclear. Drawing on semi-structured interviews conducted in 2024 with 21 hospital-based physicians from two hospitals with different incentive structures, we examine how they have responded to the new system reform in China and the underlying factors driving these responses. We use thematic analysis on the verbatim transcriptions of digital recordings of face-to-face interv..