{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:36:09Z","timestamp":1788449769936,"version":"build-2803163510"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In order to regulate the surging medical spending, the Chinese government conducted a reform of medical insurance payment directed to regional global budgets and Diagnosis-Intervention Packet (DIP) system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An interrupted time series analysis was conducted using monthly medical insurance claims data from 45,900 T2DM inpatients in S City, China between January 2020 and December 2023, comparing outcomes before and after the January 2021 DIP reform implementation across insurance types (UEBMI vs. URRBMI) and hospital types (TCM vs. general hospitals).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The DIP reform significantly reduced total hospitalization costs and length of stay overall, but divergently affected out-of-pocket ratios\u2014decreasing them for UEBMI enrollees while significantly increasing them for URRBMI patients and TCM hospital patients\u2014indicating worsened financial equity for vulnerable subgroups despite improved cost.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While the DIP payment reform effectively reduced hospitalization costs and length of stay for T2DM patients, it simultaneously exacerbated out-of-pocket inequities across insurance schemes and hospital types, indicating that future payment policies must integrate cost containment with health equity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1775557","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T14:02:21Z","timestamp":1777903341000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The impact of DIP payment reform on hospitalization costs and equity in type 2 diabetes mellitus patients: evidence from a pilot city in Central China"],"prefix":"10.3389","volume":"14","author":[{"given":"Yiming","family":"Sheng","sequence":"first","affiliation":[{"name":"School of Humanities and Management, Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Sun","sequence":"additional","affiliation":[{"name":"School of Humanities and Management, Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luyu","family":"Mo","sequence":"additional","affiliation":[{"name":"School of Humanities and Management, Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Humanities and Management, Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuehui","family":"Meng","sequence":"additional","affiliation":[{"name":"School of Humanities and Management, Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"4367","DOI":"10.2147\/DMSO.S556130","article-title":"Health management of type 2 diabetes mellitus and its complications: a machine learning algorithm-based retrospective study in Chinese communities","volume":"18","author":"Luo","year":"2025","journal-title":"Diabetes Metab Syndr Obes"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/S0140-6736(23)01301-6","article-title":"Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the global burden of disease study 2021","volume":"402","author":"Ong","year":"2023","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"112368","DOI":"10.1016\/j.diabres.2025.112368","article-title":"The global burden of early-onset type 2 diabetes mellitus caused by high body-mass index from 1990 to 2021 and projection to 2050","volume":"226","author":"Liang","year":"2025","journal-title":"Diabetes Res Clin Pract"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e0328910","DOI":"10.1371\/journal.pone.0328910","article-title":"Is the pay-for-performance program associated with better quality of life among type 2 diabetes patients, including those with gastrointestinal conditions, in Taiwan? 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