Impact of Diagnosis-Related-Group (DRG) payment on variation in hospitalization expenditure: evidence from China.
China
Diagnosis-Related-Group (DRG)
Hospitalization expenditure variation
Medical care service consistency
Payment reform
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
24 Jun 2023
24 Jun 2023
Historique:
received:
14
03
2023
accepted:
11
06
2023
medline:
26
6
2023
pubmed:
25
6
2023
entrez:
24
6
2023
Statut:
epublish
Résumé
Diagnosis-Related-Group (DRG) payment is considered a crucial means of addressing the rapid increases of medical cost and variation in cost. This paper analyzes the impact of DRG payment on variation in hospitalization expenditure in China. Patients with chronic obstructive pulmonary disease (COPD), acute myocardial infarction (AMI) and cerebral infarction (CI) in a Chinese City Z were selected. Patients in the fee-for-service (FFS) payment group and the DRG payment group were used as the control group and intervention group, respectively, and propensity-score-matching (PSM) was conducted. Interquartile distance (IQR), standard deviation (SD) and concentration index were used to analyze variation and trends in terms of hospitalization expenditure across the different groups. After DRG payment reform, the SD of hospitalization expenditure in respect of the COPD, AMI and CI patients in City Z decreased by 11,094, 4,833 and 4,987 CNY, respectively. The concentration indices of hospitalization expenditures for three diseases are all below 0 (statistically significant), with the absolute value tending to increase year by year. DRG payment can be seen to guide medical service providers to provide effective treatment that can improve the consistency of medical care services, bringing the cost of medical care closer to its true clinical value.
Sections du résumé
BACKGROUND
BACKGROUND
Diagnosis-Related-Group (DRG) payment is considered a crucial means of addressing the rapid increases of medical cost and variation in cost. This paper analyzes the impact of DRG payment on variation in hospitalization expenditure in China.
METHOD
METHODS
Patients with chronic obstructive pulmonary disease (COPD), acute myocardial infarction (AMI) and cerebral infarction (CI) in a Chinese City Z were selected. Patients in the fee-for-service (FFS) payment group and the DRG payment group were used as the control group and intervention group, respectively, and propensity-score-matching (PSM) was conducted. Interquartile distance (IQR), standard deviation (SD) and concentration index were used to analyze variation and trends in terms of hospitalization expenditure across the different groups.
RESULTS
RESULTS
After DRG payment reform, the SD of hospitalization expenditure in respect of the COPD, AMI and CI patients in City Z decreased by 11,094, 4,833 and 4,987 CNY, respectively. The concentration indices of hospitalization expenditures for three diseases are all below 0 (statistically significant), with the absolute value tending to increase year by year.
CONCLUSION
CONCLUSIONS
DRG payment can be seen to guide medical service providers to provide effective treatment that can improve the consistency of medical care services, bringing the cost of medical care closer to its true clinical value.
Identifiants
pubmed: 37355657
doi: 10.1186/s12913-023-09686-z
pii: 10.1186/s12913-023-09686-z
pmc: PMC10290781
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
688Informations de copyright
© 2023. The Author(s).
Références
Int J Health Plann Manage. 2020 May;35(3):760-772
pubmed: 31802556
Surgery. 2017 Sep;162(3):592-604
pubmed: 28728882
Health Care Manage Rev. 2008 Oct-Dec;33(4):341-9
pubmed: 18815499
Qual Manag Health Care. 2010 Jan-Mar;19(1):17-24
pubmed: 20042930
J Surg Res. 2018 Aug;228:299-306
pubmed: 29907225
Cochrane Database Syst Rev. 2021 Jan 20;1:CD011865
pubmed: 33469932
J Hosp Med. 2017 Oct;12(10):818-825
pubmed: 28991947
PLoS One. 2015 Apr 17;10(4):e0122695
pubmed: 25884623
BJOG. 2018 Jun;125(7):829-839
pubmed: 29090498
Postgrad Med J. 2013 Jun;89(1052):316-22
pubmed: 23515348
Malawi Med J. 2020 Mar;32(1):37-44
pubmed: 32733658
JAMA Intern Med. 2017 May 1;177(5):675-682
pubmed: 28288254
Stroke. 2007 Apr;38(4):1309-12
pubmed: 17332446
Int J Environ Res Public Health. 2018 Jun 29;15(7):
pubmed: 29966240
Eur J Health Econ. 2019 Mar;20(2):217-232
pubmed: 29974285
Ann Thorac Surg. 2019 Dec;108(6):1710-1716
pubmed: 31400321
CMAJ Open. 2020 May 7;8(2):E328-E337
pubmed: 32381684
Int J Environ Res Public Health. 2021 Dec 02;18(23):
pubmed: 34886448
Health Aff (Millwood). 2015 Oct;34(10):1745-52
pubmed: 26438752
JAMA. 1990 Oct 17;264(15):1953-5
pubmed: 2120473
Cancer. 2020 Apr 15;126(8):1622-1631
pubmed: 31977081
PLoS One. 2020 Oct 27;15(10):e0241179
pubmed: 33108373
Hepatobiliary Surg Nutr. 2020 Dec;9(6):771-773
pubmed: 33299831
PLoS One. 2018 Mar 7;13(3):e0193273
pubmed: 29513712
Health Serv Manage Res. 2001 May;14(2):71-81
pubmed: 11373998
Risk Manag Healthc Policy. 2021 Jun 01;14:2263-2276
pubmed: 34104017
BMC Health Serv Res. 2013 Dec 05;13:505
pubmed: 24308304
Perspect Healthc Risk Manage. 1991 Fall;11(4):19-25
pubmed: 10113806
Health Aff (Millwood). 2008 Mar-Apr;27(2):460-8
pubmed: 18332503
Med Care. 1986 May;24(5):388-97
pubmed: 3084888
Int J Environ Res Public Health. 2018 Dec 13;15(12):
pubmed: 30551561
Spine (Phila Pa 1976). 2016 Jul 1;41(13):1111-1117
pubmed: 26780612
Clin Exp Neuroimmunol. 2017 Nov;8(4):318-326
pubmed: 29242717
Cardiovasc Interv Ther. 2022 Jan;37(1):1-34
pubmed: 35018605