Study on the spillover effects of DRG payment reform:Evidence from the level and structure of medical expenses among non-local inpatients
10.3969/j.issn.1674-2982.2025.11.007
- VernacularTitle:DRG付费改革的溢出效应研究
- Author:
Xue LUO
1
;
Qiang YAO
;
Miao ZHANG
;
Hai-ni JIANG
;
Xiao-dan ZHANG
;
Yi PEI
Author Information
1. 武汉大学政治与公共管理学院 湖北 武汉 430072
- Publication Type:Journal Article
- Keywords:
Diagnosis-Related Groups(DRG);
Non-local medical treatment;
Medical expenses;
Spillover effect;
Difference-in-Differences
- From:
Chinese Journal of Health Policy
2025;18(11):48-56
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aims to investigate the spillover effects of the Diagnosis-Related Groups payment reform on medical expenditures.Methods:Based on the medical record data of inpatients in a tertiary Grade A hospital in Wuhan,Hubei Province,the Difference-in-Differences method was applied to estimate the impact of the DRG reform on medical expenditures for non-local patients.Results:After the implementation of DRG payment,the total medical expenses(β=-0.13),out-of-pocket expenses(β=-0.22),drug expenses(β=-0.25),consumable expenses(β=-0.26)decreased significantly.Meanwhile,the reduction ranges of the level and proportion of out-of-pocket expenses for non-local inpatients were significantly larger than those for local inpatients.However,the reduction range of the proportion of drug expenses for non-local inpatients was significantly smaller than that for local inpatients.The gaps between the two groups in terms of the level of out-of-pocket expenses and the proportion of drug expenses gradually narrowed.Conclusion:The DRG payment reform has produced a significant spillover effect,leading to a decrease in the medical expense level and an improvement in the expense structure for non-local inpatients.However,the medical expenses of non-local inpatients remain relatively high.It is suggested to accelerate the inclusion of non-local inpatients in disease-specific payment management and strengthen the coordination between the hospital's internal operation management and the reform of medical insurance payment methods.
