Analysis on the Preliminary Effect of Payment Reform in a Chinese Medicine Hospital Based on Interrupted Time Series
- VernacularTitle:基于间断时间序列的中医类医院支付方式改革初步效果分析
- Author:
Xiaoyu ZHANG
1
;
Tianshu CHU
;
Lili WANG
;
Limei JING
Author Information
1. 上海中医药大学公共健康学院 上海 201203
- Keywords:
Chinese medicine hospitals;
DIP insurance payment reform;
effect;
interrupted time series
- From:
Chinese Health Economics
2024;43(9):29-34,39
- CountryChina
- Language:Chinese
-
Abstract:
Objective:In the background of the national promotion of DIP insurance payment reform,using empirical data to evaluate the initial effects of payment reforms in typical traditional Chinese medicine hospitals.Methods:It collected inpatient case data from a Chinese medicine hospital in S city,encompassing a total of 207 500 cases from 2016 to 2022,and the differences between before and after the reform were analyzed using key indicators such as medical costs.Interrupted time series was applied to analyze the initial effects of the reform based on three intervention time points:reform implementation,epidemic development and static management.Logistic regression was applied to explore the main influencing factors,and recommendations for refinement were made based on the results of the key informant interviews.Results:It was found that the percentage of the high hospitalization cost group,high self-pay cost group and high bed-day cost group increased after the reform.There was an overall increasing trend in bed-day costs after the reform.Age,being married,operation times and average grade of operations,and death were the common influences.Conclusion:The initial stage of the DIP insurance payment reform was not effective in regulating medical costs.Demographic changes,strong intervention in epidemics,and the tendency of Chinese medicine hospitals to perform surgeries all tend to lead to an increase in hospitalization costs.At the same time,factors such as the shortage of policy interpretation and the lack of incentives for medical staff have affected the effectiveness of the reform.It was suggested that the DIP insurance payment reform of the Chinese medicine hospitals should be further promoted by strengthening the interpretation of policies and changing the solidification model,establishing positive incentives for medical staff,and adding indicators of traditional Chinese medicine characteristics.This will further fully leverage the advantages of Chinese medicine characteristics and enhance the substance and quality of Chinese medicine services.
