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June 29, 2026Cost Effectiveness and Resource AllocationOpen Access

Understanding provider behavioral responses to capitation prepayment systems: an integrated mixed-methods approach

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Authors

TZTao ZhangHangzhou Normal UniversityBLBoyu LiHangzhou Normal UniversityJLJing LiuShantou University

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Implication

Mixed-methods study investigates capitation prepayment effects on provider behavior in China's healthcare system, suggesting implications for policy design.

Key Points

  • This study aims to explore how various factors influence provider responses to capitation prepayment in healthcare delivery.
  • Conducted a mixed-methods study in Datong prefecture, China, involving 63 semi-structured interviews.
  • Applied Latent Dirichlet Allocation (LDA) for qualitative data analysis and Social Network Analysis (SNA) for factor interrelationships.
  • Developed a System Dynamics Model (SDM) using longitudinal data from 15 county hospitals (2015–2019) to simulate incentive mechanisms.
  • Management strategies were identified as the most direct factor affecting provider behavior under capitation pay, driven by cost-control measures.
  • External environmental factors and institutional resources moderated the influence of payment incentives.
  • SDM simulations showed potential unintended consequences, such as cost-shifting from inpatient to outpatient services.

Cite This Study

Zhang et al. (2026) studied this question.

synapsesocial.com/papers/6a420b51f91bb43ea919262ehttps://doi.org/10.1186/s12962-026-00790-5
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