The impact of DIP payment on medical expense and efficiency in public hospitals:An empirical study based on the difference-in-differences method
10.3969/j.issn.1674-2982.2025.07.005
- VernacularTitle:DIP付费对公立医院医疗服务费用及效率的影响
- Author:
Meng-ya SUN
1
;
Zhi-yong LIU
;
Qian-peng LYU
;
Zhi-fan KOU
;
Can LU
;
Sheng-nan LI
Author Information
1. 华中科技大学同济医学院医药卫生管理学院 湖北 武汉 430030
- Publication Type:Journal Article
- Keywords:
DIP payment;
Medical expense structure;
Medical service efficiency;
Difference-in-differences method(DID)
- From:
Chinese Journal of Health Policy
2025;18(7):35-43
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the impact of Diagnosis-Intervention Packet(DIP)payment reform on medical service costs and efficiency for inpatients in public hospitals,and to compare differences between surgical and medical groups.Methods:A quasi-experimental design was employed,using 605 636 discharged patients from a tertiary hospital in Hebei Province between January 2020 and March 2025 as the sample.The difference-in-differences(DID)model was used to analyze the changes in key indicators between the DIP settlement group(intervention group)and the non-DIP settlement group(control group).Results:Total hospitalization costs,out-of-pocket expenses,and medication costs were significantly reduced in the DIP settlement group(P<0.05),while costs for examinations,nursing,laboratory tests,and treatments increased significantly(P<0.05).Material costs increased by 30.7%in the surgical group(P<0.1)and decreased by 19.8%in the medical group(P<0.01).In terms of efficiency,the average length of stay,time,and cost consumption index all decreased(P<0.01),while the proportion of medical services increased(P<0.01).The case mix index(CMI)showed no significant changes.Conclusion:The DIP reform effectively controlled costs and improved efficiency,but it also resulted in cost shifting and departmental disparities.Therefore,it is necessary to optimize cost control and departmental management policies.
