Evidence map›Paper›PMID 36793088›Full record

ArticleBMC health services research2023

How do inpatients' costs, length of stay, and quality of care vary across age groups after a new case-based payment reform in China? An interrupted time series analysis.

Ya-Jing Chen, Xin-Yu Zhang, Xue Tang, Jia-Qi Yan, Meng-Cen Qian, Xiao-Hua Ying

Abstract read
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In one paragraph

Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ya-Jing Chen *School of Public Health, Fudan University, Shanghai, China.
Xin-Yu Zhang *School of Public Health, Fudan University, Shanghai, China.
Xue TangSchool of Public Health, Fudan University, Shanghai, China.
Jia-Qi YanSchool of Public Health, Fudan University, Shanghai, China.
Meng-Cen QianSchool of Public Health, Fudan University, Shanghai, China.
Xiao-Hua YingSchool of Public Health, Fudan University, Shanghai, China. xhying@fudan.edu.cn.

Funding

National Healthcare Security Research Center of Capital Medical University YB2020B01the National Natural Science Foundation (NSFC) of China 72074051
6 · The paper itself

Abstract

contextA patient classification-based payment system called diagnosis-intervention packet (DIP) was piloted in a large city in southeast China in 2018.

objectiveThis study evaluates the impact of DIP payment reform on total costs, out-of-pocket (OOP) payments, length of stay (LOS), and quality of care in hospitalised patients of different age.

methodsAn interrupted time series model was employed to examine the monthly trend changes of outcome variables before and after the DIP reform in adult patients, who were stratified into a younger (18-64 years) and an older group (≥ 65 years), further stratified into young-old (65-79 years) and oldest-old (≥ 80 years) groups.

resultsThe adjusted monthly trend of costs per case significantly increased in the older adults (0.5%, P = 0.002) and oldest-old group (0.6%, P = 0.015). The adjusted monthly trend of average LOS decreased in the younger and young-old groups (monthly slope change: -0.058 days, P = 0.035; -0.025 days, P = 0.024, respectively), and increased in the oldest-old group (monthly slope change: 0.107 days, P = 0.030) significantly. The changes of adjusted monthly trends of in-hospital mortality rate were not significant in all age groups.

conclusionImplementation of the DIP payment reform associated with increase in total costs per case in the older and oldest-old groups, and reduction in LOS in the younger and young-old groups without deteriorating quality of care.

Indexed as

Health ExpendituresInpatientsAgedAged, 80 and overChinaHumansInterrupted Time Series AnalysisLength of StayCase-based paymentCostDiagnosis-intervention packetOlder adultOut-of-pocket paymentPayment reformQuality of care

Identifiers

PMID36793088
PMCPMC9933283

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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.