Study on Impact of Diagnosis-Intervention Packet Reform on the Quality of Healthcare
- VernacularTitle:DIP改革对医疗服务质量的影响研究
- Author:
Xinyu ZHANG
1
;
Jiaqi YAN
;
Ruixin WANG
;
Dawei LV
;
Mengcen QIAN
;
Xiaohua YING
Author Information
1. 复旦大学公共卫生学院 上海 200032
- Keywords:
payment system reform;
Diagnosis-Intervention Packet(DIP);
quality of healthcare;
impact study
- From:
Chinese Hospital Management
2023;43(12):16-19
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the change of healthcare quality after the Diagnosis-Intervention Packet(DIP)payment system reform and provide evidence for improving payment system reform in China.Methods It collected discharge records of hospitalized patients with employee basic medical insurance scheme in first DIP pilot hospitals of a city from July 2017 to June 2021.It included three death-related measures and two readmission-related mea-sures,which were all risk-adjusted considering the patient mix.It used t test to compare their differences before and after the DIP reform in July 2019.Results After the risk-adjustment,mortality rate of surgical patients,mortality rate of patients in low-risk DIP groups,all-cause readmission rate within 30 days after discharge and readmission rate with the same principal diagnosis within 30 days after discharge declined 0.06 percentage points(P=0.031),0.15 percentage points(P=0.001),0.47 percentage points(P＜0.001)and 0.72 percentage points(P＜0.001),respectively.Conclusion No current evidences indicated negative impacts of the DIP payment reform on the quality of healthcare in the city.Case-based payment pilot cities should closely monitor the change of healthcare quality after the reform.
