Impact of diagnosis-intervention packet payment reform on hospitalization service capacity and patients′ economic burden
10.3760/cma.j.cn111325-20240614-00488
- VernacularTitle:按病种分值付费改革对住院服务能力和患者经济负担的影响分析
- Author:
Haomiao LI
1
;
Hualian LUO
;
Nuoyan XU
;
Junnan JIANG
;
Yixin ZENG
;
Jiangyun CHEN
Author Information
1. 武汉大学政治与公共管理学院，武汉 430072
- Publication Type:Journal Article
- Keywords:
Hospitals, public;
Diagnosis-intervention packet payment;
Service quality;
Service efficiency;
Economic burden;
Interrupted time-series analysis;
Patients
- From:
Chinese Journal of Hospital Administration
2025;41(6):457-461
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the impact of diagnosis-intervention packet payment (DIP) reform on hospitalization service capacity and patients′ economic burden, for references for promoting China′s medical insurance payment reform.Methods:Data were collected from the discharge summarizes of 116 545 hospitalized patients from a tertiary hospital in Guangdong Province. Among them, there were 42 534 cases before the DIP reform (January 2016 to December 2017) and 74 011 cases after the reform (January 2018 to December 2020). The all-cause in-hospital mortality rate, length of hospital stay, disease severity, readmission rate within 30 days, total hospitalization costs, and patient out of pocket expenses were used as evaluation indicators for hospitalization service capacity and patient economic burden. Intermittent time series analysis was conducted to examine the changes in indicators before and after DIP reform.Results:The slope of the change trend of all-cause in-hospital mortality rate and readmission rate within 30 days before and after DIP reform was not statistically significant ( P<0.05); The length of hospital stay showed a decreasing trend before the reform ( P=0.047), but the trend after the reform was not statistically significant ( P=0.776); The change trend of disease severity before the reform was not statistically significant ( P=0.682), but showed a significant upward trend after the reform ( P=0.012); The total hospitalization costs significantly increased during the reform ( P<0.001), but the trend of change after the reform was not statistically significant ( P=0.431); The patient′s out of pocket expenses showed an upward trend before the reform ( P=0.001), but the change trend after the reform was not statistically significant ( P=0.757). Conclusions:DIP reform could help hospitals improve their inpatient service capabilities and enhance their functional positioning; Strengthen medical cost management and control the increase in economic burden on hospitalized patients.
