Chang Jinghui, Chen Siyi, Li Anqi, Yang Xixi, Luo Hualian, Yilamu Maidina, Fu Bingqian, Xu Nuoyan, Liu Jing, Tian Huishu
School of Health Management, Southern Medical University, Guangzhou, China.
Guangzhou First People's Hospital, Guangzhou, China.
Front Public Health. 2025 May 30;13:1569855. doi: 10.3389/fpubh.2025.1569855. eCollection 2025.
The Diagnosis-Intervention Packet (DIP), a medical insurance payment management system utilizing big data, has been piloted in 12 cities by the National Healthcare Security Administration in China starting in 2021. Guangzhou is one of the pilot cities, and it has demonstrated significant success in the DIP payment reform, with its practical experience being affirmed and promoted by the National Health Department. In this study, researchers conducted field visits to a public hospital in Guangzhou to understand the internal responses to the DIP reform and the cognitive attitudes of relevant personnel. The analysis of the positive and negative factors affecting the implementation of the reform and the proposed measures to optimize internal hospital management are expected to provide practical evidence for the implementation of DIP payment reform in other public hospitals.
This study develops an interview guide based on the Consolidated Framework for Implementation Research (CFIR) and conducts one-on-one semi-structured interviews offline with personnel from a Grade A tertiary public hospital in Guangzhou. Employing rapid qualitative analysis techniques and utilizing NVivo 14.0 for coding CFIR-structured texts related to implementation, the study integrates five dimensions: innovation, inner and outer context, individuals, and the implementation process. It identifies factors that facilitate and hinder the implementation of the Diagnosis-Intervention Packet (DIP) payment reform, thereby proposing optimized internal management strategies for public hospitals to cope with DIP payment reforms.
This study will provide significant insights for optimizing the internal management of public hospitals in the context of DIP payment reform. It offers a reference for optimizing internal management in tertiary public hospitals in China, aiming to achieve standardized, healthy, collaborative, and high-quality development.
诊断-干预包（DIP）是一种利用大数据的医疗保险支付管理系统，自2021年起由中国国家医疗保障局在12个城市进行试点。广州是试点城市之一，在DIP支付改革方面取得了显著成效，其实践经验得到了国家卫生部门的肯定和推广。在本研究中，研究人员对广州一家公立医院进行了实地走访，以了解其对DIP改革的内部反应以及相关人员的认知态度。分析影响改革实施的正负因素，并提出优化医院内部管理的措施，有望为其他公立医院实施DIP支付改革提供实践依据。
本研究基于实施研究综合框架（CFIR）编制了访谈指南，并对广州一家三级甲等公立医院的人员进行了线下一对一的半结构化访谈。采用快速定性分析技术，利用NVivo 14.0对与实施相关的CFIR结构化文本进行编码，该研究整合了五个维度：创新、内外部环境、个人和实施过程。识别促进和阻碍诊断-干预包（DIP）支付改革实施的因素，从而提出公立医院应对DIP支付改革的优化内部管理策略。
本研究将为在DIP支付改革背景下优化公立医院内部管理提供重要见解。它为中国三级公立医院优化内部管理提供了参考，旨在实现规范化、健康化、协同化和高质量发展。
