ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Policy
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1609842
This article is part of the Research TopicPublic Health Outcomes: The Role of Social Security Systems in Improving Residents' Health WelfareView all 63 articles
Impact of the health insurance deregulation policy for cross-regional healthcare on hospitalization visits and expenses of patients with ischemic heart disease: An interrupted time series analysis
Provisionally accepted
- 1Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng, China
- 2Beijing Normal University, Beijing, Beijing Municipality, China
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The health insurance deregulation policy aimed to enhance healthcare accessibility by eliminating intra-provincial administrative hurdles. However, its impact on hospitalization patterns of high-burden chronic conditions like ischemic heart disease (IHD) remains unexamined.Methods Interrupted time-series analysis (ITSA) was employed to evaluate weekly hospitalization visits and expenses for 8,520 IHD inpatients across three Hebei counties (January 2021-July 2023). Models assessed immediate and longitudinal changes post-policy, adjusting for autocorrelation and seasonal trends.Policy implementation triggered an immediate 20.27 surge in weekly hospitalizations (P=0.006), with sustained utilization unaffected (β3=0.17, P=0.619).Per-visit hospitalization expenses maintained pre-deregulation policy declining trends (-126.71 CNY/week pre-policy vs. -32.04 CNY/week post-policy), despite a non-significant instantaneously increase by 478.43 (P=0.723) in the first week following the implementation of this policy. Additionally, the health insurance deregulation policy reversed the weekly trend of insurance reimbursement costs per visit from decreasing (-81.98 CNY/week) to increasing trajectories (1.95 CNY/week, P=0.004).The health insurance deregulation policy successfully expanded IHD care access without exacerbating financial burdens, demonstrating that administrative simplification can coexist with cost containment under concurrent payment reforms.
Keywords: Insurance deregulation, direct settlement, Interrupted time-series analyses, Ischemic Heart Disease, Hospitalization expenses, accessibility
Received: 11 Apr 2025; Accepted: 16 Jun 2025.
Copyright: © 2025 CUI, Wang, C'heng, Wang, Feng and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Rui-Hua Feng, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng, China
Huimin Yang, Beijing Normal University, Beijing, 100875, Beijing Municipality, China
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