Quantitative evaluation of China’s commercial health insurance policies based on the policy modeling consistency index model

Abstract Objective This study aims to quantitatively evaluate China’s commercial health insurance (CHI) policies and provide a reference for improving the policy. Methods By means of the text mining and literature research method, the Policy Modeling Consistency Index (PMC-index) model of CHI polici...

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Main Authors: Liujin Zhang, Wenwen Ma, Chao Zheng, Jiling Song, Qiang Sun, Jia Yin
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Health Services Research
Subjects:
Online Access:https://doi.org/10.1186/s12913-025-12886-4
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author Liujin Zhang
Wenwen Ma
Chao Zheng
Jiling Song
Qiang Sun
Jia Yin
author_facet Liujin Zhang
Wenwen Ma
Chao Zheng
Jiling Song
Qiang Sun
Jia Yin
author_sort Liujin Zhang
collection DOAJ
description Abstract Objective This study aims to quantitatively evaluate China’s commercial health insurance (CHI) policies and provide a reference for improving the policy. Methods By means of the text mining and literature research method, the Policy Modeling Consistency Index (PMC-index) model of CHI policies was constructed. The model was used to analyze the 22 policies individually and as a whole to describe the current situation of CHI policies in China. Results The PMC-index model consisted of 10 primary variables and 41 secondary variables. This study found that the average PMC index of the 22 policies included is 7.48, suggesting that existing policies are generally of high quality. Among them, good policies accounted for 18.18%, and excellent policies accounted for 81.82%. Among the primary variables, X10 (policy disclosure) had the highest score, and the scores of other primary variables were ranked as X3 (policy recipients) > X5 (policy content) > X6 (policy tools) > X8 (cooperation and connection) > X7 (content evaluation) > X1 (policy nature) > X9 (policy goals) > X4 (policy incentives) > X2 (policy timeliness). Conclusions At present, China’s CHI policies are generally at an excellent level. However, there is still room for improvement with regard to “policy incentives, policy goals, content evaluation, policy tools and policy content”. We recommend that policymakers optimize China’s CHI policies by improving the policy incentive mechanism; balancing policy goals; clarifying task distribution; optimizing policy tool structure; and developing inclusive health insurance.
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spelling doaj-art-ac723538c67e433282ddef6d1876b23b2025-08-20T03:24:29ZengBMCBMC Health Services Research1472-69632025-05-0125111110.1186/s12913-025-12886-4Quantitative evaluation of China’s commercial health insurance policies based on the policy modeling consistency index modelLiujin Zhang0Wenwen Ma1Chao Zheng2Jiling Song3Qiang Sun4Jia Yin5Center for Health Policy and Health Economics, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical CollegeWeihai City Health CommissionShandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong UniversityZhucheng People’s HospitalDepartment of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong UniversityDepartment of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong UniversityAbstract Objective This study aims to quantitatively evaluate China’s commercial health insurance (CHI) policies and provide a reference for improving the policy. Methods By means of the text mining and literature research method, the Policy Modeling Consistency Index (PMC-index) model of CHI policies was constructed. The model was used to analyze the 22 policies individually and as a whole to describe the current situation of CHI policies in China. Results The PMC-index model consisted of 10 primary variables and 41 secondary variables. This study found that the average PMC index of the 22 policies included is 7.48, suggesting that existing policies are generally of high quality. Among them, good policies accounted for 18.18%, and excellent policies accounted for 81.82%. Among the primary variables, X10 (policy disclosure) had the highest score, and the scores of other primary variables were ranked as X3 (policy recipients) > X5 (policy content) > X6 (policy tools) > X8 (cooperation and connection) > X7 (content evaluation) > X1 (policy nature) > X9 (policy goals) > X4 (policy incentives) > X2 (policy timeliness). Conclusions At present, China’s CHI policies are generally at an excellent level. However, there is still room for improvement with regard to “policy incentives, policy goals, content evaluation, policy tools and policy content”. We recommend that policymakers optimize China’s CHI policies by improving the policy incentive mechanism; balancing policy goals; clarifying task distribution; optimizing policy tool structure; and developing inclusive health insurance.https://doi.org/10.1186/s12913-025-12886-4Commercial health insurancePMC-index modelQuantitative evaluationCurrent statusOptimization
spellingShingle Liujin Zhang
Wenwen Ma
Chao Zheng
Jiling Song
Qiang Sun
Jia Yin
Quantitative evaluation of China’s commercial health insurance policies based on the policy modeling consistency index model
BMC Health Services Research
Commercial health insurance
PMC-index model
Quantitative evaluation
Current status
Optimization
title Quantitative evaluation of China’s commercial health insurance policies based on the policy modeling consistency index model
title_full Quantitative evaluation of China’s commercial health insurance policies based on the policy modeling consistency index model
title_fullStr Quantitative evaluation of China’s commercial health insurance policies based on the policy modeling consistency index model
title_full_unstemmed Quantitative evaluation of China’s commercial health insurance policies based on the policy modeling consistency index model
title_short Quantitative evaluation of China’s commercial health insurance policies based on the policy modeling consistency index model
title_sort quantitative evaluation of china s commercial health insurance policies based on the policy modeling consistency index model
topic Commercial health insurance
PMC-index model
Quantitative evaluation
Current status
Optimization
url https://doi.org/10.1186/s12913-025-12886-4
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AT jilingsong quantitativeevaluationofchinascommercialhealthinsurancepoliciesbasedonthepolicymodelingconsistencyindexmodel
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