The impact of DRG payment reform on the flow and cost of delivery patients in a city
10.3760/cma.j.cn111325-20201021-02052
- VernacularTitle:DRG支付方式改革对某市分娩患者流向和费用的影响
- Author:
Zaixin GUO
1
;
Wen FENG
Author Information
1. 北京大学公共卫生学院卫生政策与管理系 100191
- Keywords:
Diagnosis-related groups;
Reform of payment methods;
Delivery;
Cesarean section
- From:
Chinese Journal of Hospital Administration
2021;37(8):653-657
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the impact of the payment reform of diagnosis related groups(DRG)on the flow direction and cost of delivery patients in a city.Methods:Using the data of new cooperative medical system from all 13 pilot hospitals carrying out DRG payment reform in a city from October 2016 to December 2019, the changes of delivery place, delivery mode and delivery cost before and after the reform were analyzed, and the change trend of the three was analyzed by interrupted time series.Results:The proportion of maternal delivery in secondary hospitals increased from 52.79%(8 246/15 620)before the reform(October 2016 to September 2017)to 59.83%(21 229/35 485)after the reform(April 2018 to December 2019). The cesarean section rate of women in secondary hospitals decreased from 38.25% before the reform to 37.91% after the reform, and the average cost of cesarean section increased from 4226.61 yuan to 4432.67 yuan. The cesarean section rate of women in tertiary hospitals increased from 36.03% before the reform to 39.18% after the reform, and the average cost of cesarean section increased from 6363.81 yuan to 7543.29 yuan.Conclusions:After the implementation of the DRG payment reform in a city, delivery services flowed to secondary hospitals, the growth of cesarean section rate slowed down, and delivery costs continued to increase, but the growth trend slowed down.
