Developing supportive policy environments for hospice care in china: a quantitative policy evaluation based on the PMC-Index model

Abstract Background Public policies play a crucial role in enhancing practical hospice care services and have attracted significant attention in China in recent years. However, there is a lack of research systematically evaluating hospice care policies from an empirical perspective. Objectives To address this gap, we aimed to define and assess overall and individual indicators of hospice care policy importance, coherence, and performance in central, provincial, and local government policy guidelines in China. Methods We applied content analysis and text mining to 112 hospice care policy documents. Using the Policy Modeling Consistency Index (PMC-Index) model, we developed a comprehensive evaluation framework comprising 10 primary and 47 secondary indicators. Subsequently, we quantitatively evaluated 18 selected policy samples through both multidimensional holistic and individual-sample analyses, and examined improvement trends in three national-level stand-alone hospice care strategies. Results The average PMC-Index score of the 18 selected policy samples was 7.20 (out of 10.00), indicating a Good level of consistency. Two policies achieved an Excellent rating, eight were rated as Good, six Acceptable, and two Low. In terms of the 10 policy dimensions, Policy nature (X1) and Policy tools (X3) exhibited excellent performance, whereas Policy equity (X6) and Policy guarantee (X8) showed unsatisfactory performance. Notably, all three national-level stand-alone strategies were rated at the Good level and demonstrated improvements across different pilot periods. Conclusions Hospice care policies in China are considered comprehensive and rational, yet they have the potential for further improvement, especially in the areas of policy equity, guarantee of implementation, timeliness coordination, and multi-agent collaboration. Moreover, a series of practical national strategies play a significant role in the policy system. These findings offer valuable insights into the strengths and limitations of China’s hospice care policies, particularly from perspectives of policy equity and policy innovation. This serves as a reference for establishing a supportive policy environment conducive to the high-quality development of hospice care.