Impact of DRG payment reform on the length of stay and expenses of patients in pilot medical institutions of Beijing
10.3760/cma.j.cn111325-20241107-00939
- VernacularTitle:DRG付费改革对北京市试点医疗机构患者住院时间和费用的影响分析
- Author:
Moning GUO
1
;
Yin CHEN
;
Xue WU
;
Yelong QIU
;
Airan DONG
;
Tinghui FU
;
Yi WANG
Author Information
1. 北京市卫生健康大数据与政策研究中心，北京 101117
- Publication Type:Journal Article
- Keywords:
Diagnosis-related groups;
Medical insurance payment system;
Length of stay;
Hospitalization expenses;
Difference-in-differences model;
Medical insurance
- From:
Chinese Journal of Hospital Administration
2025;41(8):587-592
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyse the impact of diagnosis-related groups (DRG) payment reform on the length of stay and hospitalisation expenses of patients in pilot medical institutions of Beijing, for references for the formulation and optimisation of DRG payment related policies.Methods:The home page data of inpatient medical records from 56 medical institutions that implemented DRG payment in Beijing from April to October 2021 (before DRG payment reform) and April to October 2022 (after DRG payment reform). Patients participating in the basic medical insurance for urban employees in Beijing were selected as the reform group, and others served as the control group. The difference-in-differences model (DID) were used to analyse the related indicators, to evaluate the effectiveness of the reform.Results:This study comprised a total of 3 294 003 inpatients. Of them, 1 714 134 cases were in the control group (911 100 cases before the reform and 803 034 cases after) and 1 579 869 cases were in the study group (802 899 cases before the reform and 776 970 cases after). The gender, age composition and treatment methods of patients changed little before and after the reform. But the proportion of patients with severe comorbidities or complications rose from 11.11% before the reform to 13.19% after the reform. Through the analysis of the DID model, the DRG payment reform could reduce the length of stay ( P=0.001) and hospitalization expenses of patients ( P<0.001), and played a certain optimising role in the cost structure. Among them, the proportion of medical service expenses did not change significantly ( P=0.977), the proportion of inspection and testing expenses, as well as drug expenses decreased slightly ( P=0.001, P=0.004), and the proportion in consumable expenditures increased slightly ( P=0.001). Conclusions:DRG payment reform played a positive role in shortening the length of stay and hospitalization expenses. It was suggested that medical institutions in Beijing should further optimize the structure of patient hospitalization expenses, with a focus on exploring effective ways to increase the medical service revenue and reasonably control the consumables costs.
