ArticleFrontiers in public health2023
A study of the types and manifestations of physicians' unintended behaviors in the DRG payment system.
Article in Frontiers in public health, 2023. 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.
- "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
- The competition and cooperation mechanism of policy goals in China's diagnosis-related group: a quantitative analysis based on the BERTopic and Lotka-Volterra models.International journal for equity in health · 2026Article
- Changes in Hospital Malnutrition Coding Following Diagnosis-Related Group Payment Reform: Evidence From a Chinese Tertiary Hospital.Journal of evaluation in clinical practice · 2026Observational
- Prospective payment system transformation (2000-2024): temporal trends, payment architecture, and cross-national variation.Health economics review · 2026Review
- 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
- An adaptive and interpretable case grouping framework for healthcare payment systems.International journal for equity in health · 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
- Rational evaluation of computed tomography scans using a risk-adjusted model in a comprehensive public tertiary hospital in China.Frontiers in health services · 2026Article
- Financial Heterogeneity During Early Diagnosis-Related Group Payment Reform: A Two-Year Hospital-Based Study.Risk management and healthcare policy · 2026Article
- A tree-structured multiobjective optimization framework for constructing diagnosis-related groups.NPJ digital medicine · 2025Article
- Trend analysis of medical expenses under DRG payment reform in China.Scientific reports · 2025Article
- Multidisciplinary DRG management for rational medication in obstetrics: a cost analysis in Zhejiang Province.BMC health services research · 2025Article
- DRG payment for male reproductive system malignant tumor surgery: analysis and recommendations on resource consumption in a tertiary hospital in China.BMC surgery · 2025Article
- Diagnosis-related groups study of uterine leiomyoma patients based on E-CHAID.Scientific reports · 2025Article
- Impact of diagnosis-related group payment on medical expenditure and treatment efficiency on people with drug-resistant tuberculosis: a quasi-experimental study design.International journal for equity in health · 2025Article
- The impact of diagnosis-related group payment on the hospitalization expenditure and medical quality of public hospitals in China.PloS one · 2025Article
- Analysis and optimization of inpatient cost structure for fracture patients under the implementation of the DRG policy.Frontiers in public health · 2025Article
- A study on the impact of DRG payment on physicians' prescribing behavior in China: a case study of a healthcare consortium in J City.Frontiers in public health · 2025Article
- Impact of diagnosis-intervention packet payment on the consistency of hospitalization expenses across different medical insurance schemes in China.Frontiers in public health · 2025Article
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5 authors.
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Abstract
Introduction: In recent years, China has implemented the Diagnosis Related Groups (DRG) payment system as part of its healthcare insurance reimbursement policy. Numerous studies have focused on the effectiveness of DRG payment system in controlling unreasonable growth in medical expenses. However, there has been no systematic report on the types of unintended behaviors exhibited by doctors under the DRG payment system. Methods: The study first utilized interrupted time series analysis to analyze medical records and insurance data from eight hospitals. It investigated the data changes in MDC and ADRG groups before and after the implementation of the DRG payment system. Subsequently, a semi-structured interview method was employed to conduct qualitative research on the unintended behaviors of physicians, aiming to gain a more accurate understanding of specific changes in physician behavior after the implementation of the DRG payment system. Results: This study discovered that doctors engage in unintended behaviors within the framework of the DRG payment system. Discussion: In the early implementation of the DRG payment system in China, the contradictions between the flawed DRG payment methods and supporting systems and the actual diagnostic and treatment work manifested in the form of unintended doctor behaviors. Most of these unintended behaviors can be considered reasonable feedback from doctors to cope with the existing system flaws. They are conducive to identifying the deficiencies in China's DRG payment system and suggesting directions for improvement.
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