Objective To systematically evaluate the service efficiency and its differences among different types of medical institutions in Guangdong under the background of DRG payment reform,and to provide reference for optimizing regional medical insurance payment policies.Methods Using data from the Comprehensive Evaluation and Analysis Report on DRG Inpatient Medical Services in Guangdong Province in 2023,it compared the service efficiency differences among different types of medical institutions in Guangdong under the background of DRG payment reform,employing the length of stay consumption index,cost consumption index,and drug and consumable cost consumption index as research indicators.The Kruskal-Wallis H test was used to compare the service efficiency differences among different types of medical institutions in Guangdong,and linear regression analysis was applied to explore the relationship between the cost consumption index and the drug and consumable cost consumption index.Results There were statistically significant differences in the length of stay consumption index,cost consumption index,and drug and consumable cost consumption index among different types of medical institutions in Guangdong(P＜0.05).For the same disease group,the average length of hospital stay in Traditional Chinese Medicine hospitals is longer;the average hospitalization costs and drug expenditure per visit in tertiary public general hospitals are higher;while the average length of hospital stay and average hospitalization costs per visit in secondary public general hospitals,maternal and child health care hospitals,and county people's hospitals are relatively lower.Conclusion It needs to establish a quantitative management mechanism based on the DRG indicator system,improve dynamic adjustment and incentive policies for medical insurance payments,and optimize TCM-specific DRG grouping and payment standards,in order to systematically promote the reform of medical insurance payment methods.

Objective To systematically evaluate the service efficiency and its differences among different types of medical institutions in Guangdong under the background of DRG payment reform,and to provide reference for optimizing regional medical insurance payment policies.Methods Using data from the Comprehensive Evaluation and Analysis Report on DRG Inpatient Medical Services in Guangdong Province in 2023,it compared the service efficiency differences among different types of medical institutions in Guangdong under the background of DRG payment reform,employing the length of stay consumption index,cost consumption index,and drug and consumable cost consumption index as research indicators.The Kruskal-Wallis H test was used to compare the service efficiency differences among different types of medical institutions in Guangdong,and linear regression analysis was applied to explore the relationship between the cost consumption index and the drug and consumable cost consumption index.Results There were statistically significant differences in the length of stay consumption index,cost consumption index,and drug and consumable cost consumption index among different types of medical institutions in Guangdong(P＜0.05).For the same disease group,the average length of hospital stay in Traditional Chinese Medicine hospitals is longer;the average hospitalization costs and drug expenditure per visit in tertiary public general hospitals are higher;while the average length of hospital stay and average hospitalization costs per visit in secondary public general hospitals,maternal and child health care hospitals,and county people's hospitals are relatively lower.Conclusion It needs to establish a quantitative management mechanism based on the DRG indicator system,improve dynamic adjustment and incentive policies for medical insurance payments,and optimize TCM-specific DRG grouping and payment standards,in order to systematically promote the reform of medical insurance payment methods.

Guangdong province is experimenting with a model composed of various types of medical alliances, having achieved initial success with some of them and preliminarily has formed a holistic governance pattern. Experiences behind such initial success lied in a coordinated top-level design, reasonable and classified guidance, leader role of key governance subjects, and the construction of a telemedical system. However, as analyzed from the angle of collaborative governance, existing medical alliances have not yet formed a community of services, that of responsibility, that of interests, and that of services. In this consideration, the authors recommended to strengthen the collaborative governance of such alliances by respective governance subjects based on the theories of integrated medical service system and collaborative governance, eventually forming an integrated medical and health service system.

There is a high degree of information asymmetry in medical services.Public hospitals are characteristic of the nature of multi-layer principal-agent relationships.Asymmetric information can lead to inconsistent value goals between the principal and the agent,giving birth to the government regulation capture as a result.Such capture ranks a fundamental cause for diluted public welfare nature of public hospitals.To offset such capture at public hospitals calls for reconstruction of government regulation system within the framework of public hospital corporate governance at an institution level.It is also necessary to eliminate the information asymmetry and its negative results,bringing public hospitals back on track to public welfare.