ArticleBMC health services research2020
Impact of DRGs-based inpatient service management on the performance of regional inpatient services in Shanghai, China: an interrupted time series study, 2013-2019.
Article 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 27 papers.
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Who cites it
27 citing papers in PubMed.
- Evaluating departmental performance and reimbursement-cost pricing distortions under DRG-based payment: evidence from a tertiary hospital in China.BMC health services research · 2026Article
- Behavioral responses of healthcare providers to prospective payment systems: a systematic review using the WHO framework (2000-2024).Health economics review · 2026Review
- The impact of public hospital performance-based pay scheme reform on revenue structure and service efficiency under the Diagnosis-Intervention Packet payment system: evidence from a pilot city in China.BMC health services research · 2026Article
- Impact of diagnosis-related group systems on inpatient expenditures and medical quality for children with leukemia: evidence from real-world data.BMC health services research · 2026Article
- Financial Heterogeneity During Early Diagnosis-Related Group Payment Reform: A Two-Year Hospital-Based Study.Risk management and healthcare policy · 2026Article
- A real-world study on the influence of unplanned reoperations on hospitalized patients using the diagnosis-related group.Annals of medicine · 2025Article
- Medical service performance evaluation of tertiary general hospitals in Sichuan Province in China based on diagnosis-related groups.BMC health services research · 2025Article
- Impact of a new case-based payment scheme on volume distribution across public hospitals in Zhejiang, China: does 'Same disease, same price' matter.International journal for equity in health · 2025Article
- Evaluating the impact of the diagnosis-related groups payment system on laparoscopic uterine fibroid surgery outcomes: insights from a single-center study.Frontiers in public health · 2025Article
- How DRG Payment Reform Shapes Inpatient Neurological Care in an Underdeveloped Region: Evidence from a Controlled Interrupted Time Series Study in Yunnan, China.Risk management and healthcare policy · 2025Article
- Impact of DRG policy on the performance of tertiary hospital inpatient services in Chongqing, China: an interrupted time series study, 2020-2023.Frontiers in public health · 2025Article
- Evaluating medical service performance of hospitals in Sichuan Province, China: exploratory factor analysis and hierarchical clustering analysis based on diagnosis-related groups.Frontiers in public health · 2025Article
- Economic Burden and Prevention Strategies for Nosocomial Infections in Ophthalmic Surgery Under the Diagnosis-Related Group Payment Model.Risk management and healthcare policy · 2025Article
- Evaluation of the effect of DRG payment policy based on interrupted time series modeling: evidence from a tertiary hospital in Anhui Province.Health research policy and systems · 2024Article
- The influence of adverse events on inpatient outcomes in a tertiary hospital using a diagnosis-related group database.Scientific reports · 2024Article
- Evaluating the effect of health insurance reform on health equity and financial protection for elderly in low- and middle-income countries: evidences from China.Globalization and health · 2024Article
- Can single disease payment impact hospitalization expenses and quality in district hospital? A case study in Fujian, China.International journal for equity in health · 2024Article
- Article
- Effects of a Diagnosis-Related Group Payment Reform on Length and Costs of Hospitalization in Sichuan, China: A Synthetic Control Study.Risk management and healthcare policy · 2024Article
- Evaluation of inpatient services of tertiary comprehensive hospitals based on DRG payment.Frontiers in public health · 2024Article
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Abstract
backgroundThe asymmetry of information brings difficulty for government to manage public hospitals. Therefore, Jiading District of Shanghai has been establishing DRGs-based inpatient service management system (ISMS) to effectively compare the output of different hospitals through DRGs, reward desired hospital performance and enhance inpatient service capacity. However, the impact of the implementation of DRGs-based inpatient service management (ISM) policy in Jiading district is still unknow. We therefore conducted this study to evaluate the impact of DRGs-based ISM policy on the performance of inpatient service since its implementation in Jiading District, Shanghai, China in 2017.
methodsUsing an interrupted time series design, we analyzed quarterly data of seven DRGs-based performance measures from the ISMS which covered all five public hospitals in Jiading District from 2013 to 2019. We utilized the segmented linear regression model to assess the change of level and trend of performance indicators before and after ISM policy. Dickey-Fuller test was used to examine the stationary of the data. Durbin-Watson test was performed to check the series autocorrelation of indicators.
resultsSignificant changes in the following indicators were observed since the implementation of ISM policy. The case-mix index (CMI) level decreased by 0.103 (P < 0.05), the trend increased by 0.008 (P < 0.05). The total weight level decreased by 3719.05 (P < 0.05), and the trend increased by 250.13 (P < 0.05). The time efficiency index (TEI) level increased by 0.12 (P < 0.05), and the trend decreased by 0.01 (P < 0.05). The cost efficiency index (CEI) level increased by 0.31 (P < 0.05), and the trend decreased by 0.02 (P < 0.05). No significant difference was found in the change of DRGs number, inpatient mortality of low-risk group cases (IMLRG) and inpatient mortality of medium-to-low risk group cases (IMMLRG).
conclusionsFindings highlight the role of ISM policy in improving the capacity and efficiency of regional inpatient service. Three prerequisites, including a good information system, high-quality EMR data, and a management team, are needed for other countries to implement their own ISM policy to help government manage public hospitals and improve the performance of regional inpatient service.
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