Impacts of Hospital Payment Based on Diagnosis Related Groups (DRGs) with Global Budget on Resource Use and Quality of Care: A Case Study in China

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YUAN Suwei; LIU Wenwei; WEI Fengqing; ZHANG Haichen; WANG Suping; ZHU Weijun; MA Jin

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Journal: Iranian Journal of Public Health Year:2019 | Volume:48 | Issue:2 Page(s): 238-246

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Title

Impacts of Hospital Payment Based on Diagnosis Related Groups (DRGs) with Global Budget on Resource Use and Quality of Care: A Case Study in China

Author(s)

Keywords

Diagnosis-related-groups (DRGs)

Global budget

Hospital payment reform

China

Abstract

Background: China has implemented numerous pilots to shift its hospital payment mechanism from the tradi-tional retrospective cost-based system to prospective diagnosis-related-group (DRG)-based system. This study investigated the impact of the DRG payment reform with Global budget in Zhongshan, China. Methods: A total of 2895 patients diagnosed with acute myocardial infarction (AMI) were selected from local two largest tertiary hospitals, among which 727 were discharged prior to the payment reform and 2168 after-wards. Difference-in-difference (DID) regression models were used to evaluate the policy effects on patients’ percutaneous coronary intervention (PCI) use, hospital expenditures, in-hospital mortality, and readmission rates within 30 days after discharge. Results: Patients’ PCI use and hospital expenditures increased quickly after the payment reform. With patients with no local insurance scheme as reference, PCI use for local insured patients decreased significantly by 4. 55 percent (95 percent confidence interval [CI]: 0. 23, 0. 72), meanwhile the total hospital expenses decreased signif-icantly by US$986. 10 (b=-0. 15, P=0. 0037) after reform. No changes were observed with patients’ hospital mor-tality and readmission rates in our study. Conclusion: The innovative DRG-based payment reform in Zhongshan suggested a positive effect on AMI patient’ s cost containment but negative effect on encouraging resource use. It had no impacts on patients’ care quality. Cost shifting consequence from the insured to the uninsured was observed. More evidence of the im-pacts of the DRG-based payment in China’ s health scenario is needed before it is generalized nationwide.

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APA: Copy

YUAN, Suwei, LIU, Wenwei, WEI, Fengqing, ZHANG, Haichen, WANG, Suping, ZHU, Weijun, & MA, Jin. (2019). Impacts of Hospital Payment Based on Diagnosis Related Groups (DRGs) with Global Budget on Resource Use and Quality of Care: A Case Study in China. IRANIAN JOURNAL OF PUBLIC HEALTH, 48(2), 238-246. SID. https://sid.ir/paper/274989/en

Vancouver: Copy

YUAN Suwei, LIU Wenwei, WEI Fengqing, ZHANG Haichen, WANG Suping, ZHU Weijun, MA Jin. Impacts of Hospital Payment Based on Diagnosis Related Groups (DRGs) with Global Budget on Resource Use and Quality of Care: A Case Study in China. IRANIAN JOURNAL OF PUBLIC HEALTH[Internet]. 2019;48(2):238-246. Available from: https://sid.ir/paper/274989/en

IEEE: Copy

Suwei YUAN, Wenwei LIU, Fengqing WEI, Haichen ZHANG, Suping WANG, Weijun ZHU, and Jin MA, “Impacts of Hospital Payment Based on Diagnosis Related Groups (DRGs) with Global Budget on Resource Use and Quality of Care: A Case Study in China,” IRANIAN JOURNAL OF PUBLIC HEALTH, vol. 48, no. 2, pp. 238–246, 2019, [Online]. Available: https://sid.ir/paper/274989/en

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