Title: Perception-Free Payment and Continuity of Patient-Physician Relationship: How Outpatient Billing Methods Affect Patients' Choice of Follow-up Visits

Speaker: Wenhui Zhou

Time:  August 1st, 2026 (Saturday) 10:00

Venue: 405, School of Business, East China University of Science and Technology

Organizer: School of Business, East China University of Science and Technology

Guest Bio:
  Professor Wenhui Zhou is a Second-Class Professor at the School of Business Administration, South China University of Technology, and Deputy Chairman of the Academic Committee of South China University of Technology. He is Director of the Guangdong Provincial Key Laboratory of Smart Healthcare Service Management and Vice President of the Guangdong Quality Association. His research interests include healthcare management, medical service management, operations management, and supply chain management. In recent years, he has led one Key Project and four General Projects of the National Natural Science Foundation of China, with three completed projects receiving "Outstanding" ratings in post-evaluation in 2014, 2019, and 2022. His research has been published in renowned domestic and international journals such as BMJ, POM, DS, CER, NRL, Omega, EJOR, and Journal of Management Sciences in China. In 2012, he was selected for the Ministry of Education's "New Century Excellent Talents Support Program"; in 2017, he was selected for the Guangdong Provincial Department of Education's "Pearl River Scholar" Distinguished Professor Program; in 2019, he received a General Project of the National Natural Science Foundation; and in 2023, he received the Innovative Research Group Project of the National Natural Science Foundation. He received the First Prize of the Guangdong Provincial Philosophy and Social Sciences Outstanding Achievement Award in 2017 and 2025, the Second Prize of the Eighth Higher Education Research Outstanding Achievement Award in 2020, the Second Prize of the Tenth Ministry of Education Research Outstanding Achievement Award (Humanities and Social Sciences) in 2026, and the Second Prize of the Guangdong Provincial Science and Technology Progress Award in 2026.

Synopsis:

  Since 2023, the National Healthcare Security Administration has been developing data-driven healthcare. Perception-free payment is a new development that is reshaping the payment and settlement methods of outpatient services. It automatically deducts fees when the physician prescribes, allowing the treatment process to conclude within the physician's consultation room rather than at the billing counter. Beyond the convenience it brings to patients, whether this operational change affects the patient-physician relationship is a question worth examining. Continuity of the patient-physician relationship is an important indicator of healthcare quality, closely associated with lower patient mortality and fewer hospitalizations. Based on service encounter theory, this study analyzes outpatient records from a large top-tier public hospital in China that introduced perception-free payment in March 2024. Since patients voluntarily enrolled in this service at different points in time, with first-time usage also distributed across the sample period, we construct a patient-level difference-in-differences design. The sample covers 681,244 visit pairs from 119,202 patients between October 2022 and September 2025. Our findings show that adopting perception-free payment increases the probability that a patient chooses the same physician for their next visit to the same department by 1.57 percentage points. This effect increases monotonically with usage intensity, reaching 3.84 percentage points among patients who use it for every visit. Among patients with low baseline physician continuity, the effect reaches 9.71 percentage points, more than six times the overall estimate. The significant impact on the interval between visits suggests that improved continuity reflects genuine improvement in patient health status rather than a mechanical result of increased visit frequency. This study establishes the operational structure of outpatient processes as a determinant of patient-physician relationship continuity, demonstrating that payment technologies introduced as administrative efficiency tools also substantively influence the formation of therapeutic relationships.