Zhang Jin, Liu Junfeng, Qu Lingfei, Duan Zihao
Dong Fureng Institute of Economic and Social Development, Wuhan University, 299, Bali Road, Wuchang District, Wuhan City, Hubei Province, China.
The Center of Finance Research, Wuhan University, 299, Bali Road, Wuchang District, Wuhan City, Hubei Province, China.
Health Econ Rev. 2025 Jun 7;15(1):48. doi: 10.1186/s13561-025-00643-6.
This study investigates the impact of the diagnosis-related group (DRG) reimbursement system and subsidy policies on the treatment methods of traditional Chinese medicine (TCM) orthopaedic physicians. The objective is to determine the optimal subsidy amount to maximize the number of treated patients.
Using Evans' profit maximization theory, the study examines the intrinsic motivations behind physicians' behaviours and their influence on the medical market. A discontinuous time series analysis evaluates the effects of the C-DRG-based reimbursement system and subsidies on the number of treated inpatients and inpatient expenses in TCM orthopaedics.
The expanded implementation of the C-DRG-based reimbursement system substantially boosted both orthopaedic surgery and TCM technology case volumes, with 55 additional orthopaedic procedures and 200 extra TCM interventions recorded (p < 0.001).Total and surgical expenses decreased notably by 42.7% and 26.29%, respectively(p < 0.001), while inpatient expenses for TCM techniques decreased significantly by 32.63% (p < 0.05). Subsidy policies during the C-DRG-based reimbursement system implementation significantly increased the use of appropriate TCM techniques without substantially impacting total expenses. Physicians partially achieved both DRG expenses control and subsidy policy objectives by reducing total expenses and increasing TCM technique usage. The optimal subsidy amount was calculated to be 584.79 RMB, showing a linear relationship with TCM orthopaedic cases, with peak usage aligning with optimal subsidy timing.
The C-DRG-based reimbursement system and subsidy policies positively influenced the treatment methods of TCM orthopaedic physicians, increasing the number of treated cases and reducing expenses. An optimal subsidy of 584.79 RMB was identified to maximize the number of treated patients, aligning with both DRG expenses control and subsidy policy objectives.
本研究调查诊断相关分组（DRG）付费系统和补贴政策对中医骨科医生治疗方式的影响。目的是确定最优补贴金额，以使治疗患者数量最大化。
本研究运用埃文斯利润最大化理论，考察医生行为背后的内在动机及其对医疗市场的影响。间断时间序列分析评估基于中医诊断相关分组（C-DRG）的付费系统和补贴对中医骨科住院患者治疗数量和住院费用的影响。
基于C-DRG的付费系统的扩大实施显著提高了骨科手术和中医技术病例数量，记录到骨科手术增加了55例，中医干预增加了200例（p < 0.001）。总费用和手术费用分别显著下降了42.7%和26.29%（p < 0.001），而中医技术的住院费用显著下降了32.63%（p < 0.05）。在基于C-DRG的付费系统实施期间的补贴政策显著增加了适当中医技术的使用，而对总费用没有实质性影响。医生通过降低总费用和增加中医技术使用，部分实现了DRG费用控制和补贴政策目标。计算得出最优补贴金额为584.79元，与中医骨科病例呈线性关系，使用高峰与最优补贴时机一致。
基于C-DRG的付费系统和补贴政策对中医骨科医生的治疗方式产生了积极影响，增加了治疗病例数量并降低了费用。确定了584.79元的最优补贴，以使治疗患者数量最大化，这与DRG费用控制和补贴政策目标相一致。
