Luo Mingwei, Li Hongying, Li Rongyue, Wu Yugao, Lan Yuping, Xie Shiwei
Department of Medical Records Statistics, Panzhihua Central Hospital, Panzhihua, Sichuan, China.
Department of Medical Records Statistics, Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
Front Public Health. 2025 Jun 3;13:1563204. doi: 10.3389/fpubh.2025.1563204. eCollection 2025.
To evaluate the impact of DRG (Diagnosis-Related Group) payment reform on inpatient costs for four major types of surgery at a tertiary hospital in China, with a focus on its implementation in general surgery, cardiothoracic surgery, neurosurgery, and urology.
Based on inpatient data from 2019 to 2023, the study employed Propensity Score Matching (PSM) and Difference-in-Differences (DiD) models to compare inpatient cost differences between the DRG payment group and the non-DRG payment group. Concentration indices were used to assess the consistency of inpatient cost distribution.
The DRG payment reform significantly reduced the total inpatient costs for surgeries in general surgery, cardiothoracic surgery, neurosurgery, and urology, particularly in terms of drug and material expenses. Additionally, the inpatient cost distribution in the DRG payment group became more concentrated, indicating a significant reduction in the proportion of high-cost cases.
The DRG payment reform effectively controlled inpatient costs in Chinese tertiary hospitals, particularly for complex surgical procedures, and improved the efficiency of healthcare resource utilization. This study provides empirical support for the further implementation of DRG payment reform and offers policy recommendations for optimizing China's healthcare payment system.
评估疾病诊断相关分组（DRG）支付改革对中国一家三级医院四类主要手术住院费用的影响，重点关注其在普通外科、心胸外科、神经外科和泌尿外科的实施情况。
基于2019年至2023年的住院数据，本研究采用倾向得分匹配（PSM）和双重差分（DiD）模型，比较DRG支付组和非DRG支付组之间的住院费用差异。使用集中度指数评估住院费用分布的一致性。
DRG支付改革显著降低了普通外科、心胸外科、神经外科和泌尿外科手术的住院总费用，特别是在药品和材料费用方面。此外，DRG支付组的住院费用分布变得更加集中，表明高费用病例的比例显著降低。
DRG支付改革有效控制了中国三级医院的住院费用，特别是对于复杂的外科手术，并提高了医疗资源利用效率。本研究为DRG支付改革的进一步实施提供了实证支持，并为优化中国医疗支付体系提供了政策建议。
