Wang Jiayi, Chen Mengen, Yang Jingyu
School of Health Management, Gansu University of Chinese Medicine, Lanzhou, People's Republic of China.
School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, People's Republic of China.
Risk Manag Healthc Policy. 2025 Jul 11;18:2401-2411. doi: 10.2147/RMHP.S525667. eCollection 2025.
Stroke presents a significant economic burden worldwide, with the impact being especially pronounced in developing countries. China is currently implementing Diagnosis-Related Group (DRG) reforms, attempting to use more traditional Chinese medicine (TCM) modalities to alleviate the economic burden on stroke patients.
This retrospective study extracted the medical records of stroke inpatients at Qingyang City Hospital of TCM from 2017 to 2022 from China's Gansu National Health Big Data Platform. A single-group interrupted time series (ITS) design was employed to assess the impact of DRG reform on patients' hospitalization costs and length of stay (LOS). Additionally, a two-group ITS was utilized to evaluate treatment costs and medicine costs.
The single-group ITS analysis indicated that the average LOS decreased by 0.06 days per month following the reform (P < 0.05), while the average hospitalization cost declined by 48.92 yuan per month (P < 0.05). The two-group ITS results revealed a significant reduction in the average monthly cost of Western medicine by 22.67 yuan post-reform (P < 0.05), whereas the average monthly cost of Chinese medicine increased by 2.93 yuan, though this change was not statistically significant (P > 0.05). Additionally, the average monthly cost of Western medical treatment decreased by 11.24 yuan (P < 0.05). Acupuncture and massage treatment costs exhibited an initial sharp increase followed by a downward trend, with an average monthly decrease of 9.53 yuan (P < 0.05).
DRG reduced hospitalization costs and shortened the LOS of stroke patients, which may be related to the increased use of TCM in stroke treatment.
中风在全球造成了巨大的经济负担，在发展中国家这种影响尤为显著。中国目前正在实施疾病诊断相关分组（DRG）改革，试图采用更多的中医治疗方式来减轻中风患者的经济负担。
这项回顾性研究从中国甘肃国家卫生大数据平台提取了2017年至2022年庆阳市中医医院中风住院患者的病历。采用单组中断时间序列（ITS）设计来评估DRG改革对患者住院费用和住院时长（LOS）的影响。此外，采用两组ITS来评估治疗费用和药品费用。
单组ITS分析表明，改革后平均住院时长每月减少0.06天（P < 0.05），而平均住院费用每月下降48.92元（P < 0.05）。两组ITS结果显示，改革后西药平均每月费用显著降低22.67元（P < 0.05），而中药平均每月费用增加2.93元，不过这一变化无统计学意义（P > 0.05）。此外，西医治疗平均每月费用下降11.24元（P < 0.05）。针灸和按摩治疗费用起初急剧上升，随后呈下降趋势，平均每月下降9.53元（P < 0.05）。
DRG降低了中风患者的住院费用并缩短了住院时长，这可能与中风治疗中增加使用中医有关。
