SynthesisBMC health services research2020
The effects of diagnosis-related groups payment on hospital healthcare in China: a systematic review.
Synthesis in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
77 citing papers in PubMed, 1 synthesis or guideline pooled it, 115 citations in OpenAlex.
- Impact of Diagnosis-Related Groups on Inpatient Quality of Health Care: A Systematic Review and Meta-Analysis.Inquiry : a journal of medical care organization, provision and financingPooled it
- "More work means less pay": a qualitative understanding of physicians' patient selection decision-making under DRG reform in Nanjing, China.International journal for equity in health · 2026Article
- Temporal Associations and Heterogeneity of Diagnosis-Related Group (DRG) Payment Reform with Hospitalization Costs Among Patients with Colorectal Cancer in China.Healthcare (Basel, Switzerland) · 2026Article
- Personalized Precision in Healthcare Payment Systems: Insights From a Real-World Cancer Patients Cohort Study.Health care science · 2026Article
- Understanding provider behavioral responses to capitation prepayment systems: an integrated mixed-methods approach.Cost effectiveness and resource allocation : C/E · 2026Article
- Analysis of factors influencing hospitalization costs for ureteral surgery based on a DRG profit-and-loss perspective: a multicenter study.BMC health services research · 2026Article
- Ethical perceptions of DRG-based hospital financing among physicians and hospital managers in Germany: a cross-sectional survey.BMC medical ethics · 2026Article
- Impact of diagnosis-intervention packet payment reform on pediatric hospital services: an interrupted time series analysis.BMC health services research · 2026Article
- Impacts of medical insurance payment reform (DRG) on public medical institutions: evidence from pilot cities in China.BMC health services research · 2026Article
- The differential impact of Diagnosis-Related Groups (DRG) on hierarchical hospitals: an interrupted time series analysis on health expenditure structure.BMC health services research · 2026Article
- The trade-off between cost containment and quality enhancement under the DRG payment model.BMC health services research · 2026Article
- Impact of diagnosis-related group-based bundled payment on hospitalization costs and clinical outcomes in total hip arthroplasty: an interrupted time series analysis from Wenzhou, China.Frontiers in public health · 2026Article
- The impact of DIP payment reform on hospitalization costs and equity in type 2 diabetes mellitus patients: evidence from a pilot city in Central China.Frontiers in public health · 2026Article
- Six Sigma and Statistical Process Control in Clinical Pathway Management: An Evaluation Using Coefficient of Variation, Control Charts, and Process Performance Index.Risk management and healthcare policy · 2026Article
- Do non-local hospitalized patients cost more? A comparative study based on the implementation of the DRG payment.Frontiers in public health · 2026Article
- Association of DRG-based payment reform with inpatient costs and resource use among older adults: an interrupted time series study in a county-level referral hospital in China.Frontiers in public health · 2026Article
- Traditional Chinese medicine reimbursement reform in China: implementation progress, policy constraints, and optimization strategies.Frontiers in public health · 2026Article
- Impact of Diagnosis-Intervention Packet Compliance Training on Inpatient Expenditures Under Case-Based Payment Reform: A Quasi-Experimental Study Based on Discharge Records.Journal of multidisciplinary healthcare · 2026Article
- Temporal trends in gender, etiology, severity and outcomes of acute pancreatitis in a third-tier Chinese city from 2013 to 2021.Annals of medicine · 2025Article
- Can DRG payment under global budget with price adjustment curb the soaring healthcare costs? Insights from China's reform and its underlying mechanism.BMC public health · 2025Article
17 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThere has been a growing interest in using diagnosis-related groups (DRGs) payment to reimburse inpatient care worldwide. But its effects on healthcare and health outcomes are controversial, and the evidence from low- and middle- income countries (LMICs) is especially scarce. The objective of this study is to evaluate the effects of DRGs payment on healthcare and health outcomes in China.
methodA systematic review was conducted. We searched literature databases of PubMed, Cochrane Library, EMBASE, Web of Science, Chinese National Knowledge Infrastructure and SinoMed for empirical studies examining the effects of DRGs payment on healthcare in mainland China. We performed a narrative synthesis of outcomes regarding expenditure, efficiency, quality and equity of healthcare, and assessed the quality of evidence.
resultsTwenty-three publications representing thirteen DRGs payment studies were included, including six controlled before after studies, two interrupted time series studies and five uncontrolled before-after studies. All studies compared DRGs payment to fee-for-service, with or without an overall budget, in settings of tertiary (7), secondary (7) and primary care (1). The involved participants varied from specific groups to all inpatients. DRGs payment mildly reduced the length of stay. Impairment of equity of healthcare was consistently reported, especially for patients exempted from DRGs payment, including: patient selection, cost-shifting and inferior quality of healthcare. However, findings on total expenditure, out of pocket payment (OOP) and quality of healthcare were inconsistent. The quality of the evidence was generally low or very low due to the study design and potential risk of bias of included studies.
conclusionDRGs payment may mildly improve the efficiency but impair the equity and quality of healthcare, especially for patients exempted from this payment scheme, and may cause up-coding of medical records. However, DRGs payment may or may not contain the total expenditure or OOP, depending on the components design of the payment. Policymakers should very carefully consider each component of DRGs payment design against policy goals. Well-designed randomised trials or comparative studies are warranted to consolidate the evidence of the effects of DRGs payment on healthcare and health outcomes in LMICs to inform policymaking.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.