The introduction of Diagnosis Related Groups (DRGs) as a prospective payment system in many high-income countries has been accompanied by ongoing debates on how to both ethically and efficiently allocate health care resources. China has recently introduced a similar payment system for cost control, namely the case-based payment system. But the existing ethical analysis of case-based payment in the Chinese literature is scarce and implicit.
This paper aims at preparing the grounds for a discussion of the ethical implications of case-based payment in China. We first provide a brief overview of the health care system in China. Then we describe the case-based payment system as currently being implemented and situate it in the context. In the following part, we compare various types of case-based payment and DRGs with a view to their ethical implications. In the end, we present a short review of empirical studies on the effects of case-based payment in China, which will contribute to inform the ethical discussion.