{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T22:18:14Z","timestamp":1773872294881,"version":"3.50.1"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fujian Provincial Natural Science Foundation of China"},{"DOI":"10.13039\/501100013795","name":"Fujian Medical University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013795","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In 2017, China introduced clinical pathway-based single disease payment (CP-SDP) to curb healthcare costs, yet its impact is uncertain. Using uterine fibroids as a case, we evaluated its effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 4,727 hysterectomy cases for uterine fibroids from a tertiary hospital in Fujian Province between January 2014 and December 2023. Using an interrupted time series (ITS) with August 2017 as the intervention point, we fitted a segmented regression model to estimate immediate level changes and post-intervention trends. The impact of CP-SDP was evaluated across structure, process, and clinical outcome domains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The utilization of laparoscopic surgery significantly increased from 45.1 to 75.5%, accompanied by 3.51\u202fdays reduction in average hospital stay. Significant changes had occurred in the cost structure: technical service fees (e.g., pathological diagnostics [+32.4%] and imaging [+7.3%]) increased, whereas consumable costs (e.g., antibacterial drugs [\u221248.5%] and disposable supplies [\u221219.5%]) decreased significantly. Hospitalization expenses decreased by 2.7%, while the postoperative complication rate decreased from 7.8 to 4.9%. ITS analysis showed that after the policy, hospitalization expenses immediately decreased by 2265.51 \u00a5 (13.28%) and continued to decrease. The long-term trend of out of pocket expenses had shifted from increasing to decreasing, and the proportion of medical insurance reimbursement had shifted from decreasing to increasing. In 2023, out-of-pocket expenses had reached their lowest level, whereas the reimbursement ratio had peaked.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CP-SDP appears to control costs while improving care quality by promoting minimally invasive procedures and optimizing cost allocation. This approach substantially reduces patients\u2019 long-term financial burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1751890","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T14:56:00Z","timestamp":1773845760000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and economic impacts of a clinical pathway-based single disease payment policy on hysterectomy for uterine fibroids: a decade-long interrupted time series analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Hui","family":"Zheng","sequence":"first","affiliation":[{"name":"College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University","place":["Fuzhou, China"]},{"name":"Fujian Maternity and Child Health Hospital","place":["Fuzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zelong","family":"Li","sequence":"additional","affiliation":[{"name":"College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University","place":["Fuzhou, China"]},{"name":"Fujian Maternity and Child Health Hospital","place":["Fuzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hang","family":"Lin","sequence":"additional","affiliation":[{"name":"College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University","place":["Fuzhou, China"]},{"name":"Fujian Maternity and Child Health Hospital","place":["Fuzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huan","family":"Yi","sequence":"additional","affiliation":[{"name":"College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University","place":["Fuzhou, China"]},{"name":"Fujian Maternity and Child Health Hospital","place":["Fuzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiangqin","family":"Zheng","sequence":"additional","affiliation":[{"name":"College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University","place":["Fuzhou, China"]},{"name":"Fujian Maternity and Child Health Hospital","place":["Fuzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1377\/hlthaff.2018.05499","article-title":"National health expenditure projections, 2018-27: economic and demographic trends drive spending and enrollment growth","volume":"38","author":"Sisko","year":"2019","journal-title":"Health Aff (Millwood)"},{"key":"ref2","year":"2025"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1002\/hec.3292","article-title":"The effects of introducing mixed payment systems for physicians: experimental evidence","volume":"26","author":"Brosig-Koch","year":"2017","journal-title":"Health Econ"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"114601","DOI":"10.1016\/j.socscimed.2021.114601","article-title":"Hospital response to a case-based payment scheme under regional global budget: the case of Guangzhou in China","volume":"292","author":"Lai","year":"2022","journal-title":"Soc Sci Med"},{"key":"ref5","year":"2017"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"990","DOI":"10.1186\/s12913-018-3807-1","article-title":"Can single disease payment system based on clinical pathway reduce hospitalization costs in rural area? 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