The Effects of Diagnosis-Related Group Payments on Hospitalisation Costs, Length of Stay, and In-Hospital Mortality: A Case Study in China

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2025-07-06 DOI:10.1111/jep.70153

Ning Wang, Baozhen Dai, Xin Liao, Yan Sun

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引用次数: 0

Abstract

Objective

In this study, it was to evaluate the impact of diagnosis-related group (DRG) payments on hospitalisation costs, length of stay (LOS), and in-hospital mortality in Nanjing.

Methods

A quasi-natural experiment was utilised. The intervention group consisted of patients enroled in the Urban Employee Basic Medical Insurance and Urban and Rural Resident Basic Medical Insurance programmes in Nanjing, while the other patients composed the comparison group. Interrupted time-series analysis and difference-in-differences combined with propensity score matching were employed in this study. The analysis was based on a case-level data set from a tertiary hospital between January 2021 and December 2022.

Results

The introduction of the DRG payment caused a 13.5% decrease in hospitalisation costs per admission for the intervention group compared with the comparison group. Furthermore, the intervention group exhibited a slight reduction in the LOS of 0.75 days in comparison to the comparison group. No significant changes were observed in care quality, as measured by in-hospital mortality.

Conclusion

The DRG payment was effective in decreasing hospitalisation costs and length of stay. No compelling evidence was identified in terms of the changes in in-hospital mortality. The evidence from China may also be valuable to other developing countries considering the adoption of DRG payments.

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诊断相关团体支付对住院费用、住院时间和住院死亡率的影响：中国个案研究

目的本研究旨在评估南京市诊断相关组（DRG）支付对住院费用、住院时间（LOS）和住院死亡率的影响。方法采用准自然实验。干预组由参加南京市城镇职工基本医疗保险和城乡居民基本医疗保险的患者组成，其他患者组成对照组。本研究采用中断时间序列分析和差异中差异结合倾向评分匹配。该分析基于2021年1月至2022年12月期间一家三级医院的病例级数据集。结果与对照组相比，DRG支付的引入使干预组每次住院费用下降13.5%。此外，与对照组相比，干预组的LOS略有减少，为0.75天。以住院死亡率衡量，护理质量未见显著变化。结论DRG支付能有效降低住院费用和住院时间。在住院死亡率的变化方面，没有发现令人信服的证据。来自中国的证据可能对其他考虑采用DRG支付的发展中国家也很有价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.