Influence Mechanism of Capitation for Outpatient Services in Basic Medical Insurance on Medical Expenses Based on the Concept of System Dynamics: a Case Study of Outpatient Payment Mode Reform in Shengzhou, Zhejiang Province

Background Since August 2022, Shengzhou City of Zhejiang Province has been carrying out the reform of outpatient payment mode in medical insurance, gradually carrying out the reform of capitation by implementing the total budget, updating the calculation standard of capitation fee, improving the incentive and constraint mechanism and other measures, so as to encourage primary health care institutions to provide appropriate basic medical services, reduce primary medical expenses, and promote the sustainable development of medical insurance fund. Objective To analyze the influence mechanism of capitation for outpatient services in basic medical insurance on medical expenses in Shengzhou City, Zhejiang Province, and to provide reference for improving the relevant payment system. Methods Using "capitation" and "medical costs" as both English and Chinese search terms, databases such as CNKI, Wanfang, PubMed and Web of Science were searched for relevant literature on capitation from 2000-01-01 to 2022-07-31, as wel