ArticleBMJ open2024
Differences in inpatient performance of public general hospitals following implementation of a points-counting payment based on diagnosis-related group: a robust multiple interrupted time series study in Wenzhou, China.
Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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18 citing papers in PubMed, 15 citations in OpenAlex.
- Progress of Plastic and Aesthetic Industry in Mainland China: A National Data Comparison between Public and Private Hospitals.Aesthetic plastic surgery · 2026Article
- Evaluating departmental performance and reimbursement-cost pricing distortions under DRG-based payment: evidence from a tertiary hospital in China.BMC health services research · 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
- Beyond average costs: large-scale evidence on DRG payment reform and the distribution of standardized inpatient spending in China.Health economics review · 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
- A study on the impact of DRG payment reform on hospitalization costs and outcomes of patients with fractures and intervertebral disc herniations.Frontiers in public health · 2026Article
- Correlation analysis between single disease quality management and efficiency indicators of a tertiary hospital in China.BMC health services research · 2025Article
- Impact of per diem payment on medical expenditure, service efficiency, and quality of care for patients with mental disorders: an interrupted time series study.BMC health services research · 2025Article
- The Impact of DRG-Based Payment Reform on Inpatient Healthcare Utilization: Evidence from a Natural Experiment in China.Healthcare (Basel, Switzerland) · 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
- Article
- Utilization of upper gastrointestinal tumor inpatient services affected by COVID-19 in China 2018-2021: an interrupted time series analysis.Frontiers in public health · 2025Article
- Article
- Analysis of structural variations and effects of the national volume-based procurement policy on inpatient costs: a real world study of osteoporotic hip fractures in Shanghai, China.Frontiers in public health · 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
- 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
- Knowledge, attitudes, and practices among oncologists regarding the implementation of DRGs payment system: a cross-sectional study in Beijing.Frontiers in public health · 2024Article
- Healthcare providers' perceptions and experiences of kangaroo mother care for preterm infants in four neonatal intensive care units in China: a qualitative descriptive study.Frontiers in public health · 2024Article
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study measures the differences in inpatient performance after a points-counting payment policy based on diagnosis-related group (DRG) was implemented. The point value is dynamic; its change depends on the annual DRGs' cost settlements and points of the current year, which are calculated at the beginning of the following year.
designA longitudinal study using a robust multiple interrupted time series model to evaluate service performance following policy implementation.
settingTwenty-two public general hospitals (8 tertiary institutions and 14 secondary institutions) in Wenzhou, China.
interventionThe intervention was implemented in January 2020. OUTCOME MEASURES: The indicators were case mix index (CMI), cost per hospitalisation (CPH), average length of stay (ALOS), cost efficiency index (CEI) and time efficiency index (TEI). The study employed the means of these indicators.
resultsThe impact of COVID-19, which reached Zhejiang Province at the end of January 2020, was temporary given rapid containment following strict control measures. After the intervention, except for the ALOS mean, the change-points for the other outcomes (p<0.05) in tertiary and secondary institutions were inconsistent. The CMI mean turned to uptrend in tertiary (p<0.01) and secondary (p<0.0001) institutions compared with before. Although the slope of the CPH mean did not change (p>0.05), the uptrend of the CEI mean in tertiary institutions alleviated (p<0.05) and further increased (p<0.05) in secondary institutions. The slopes of the ALOS and TEI mean in secondary institutions changed (p<0.05), but not in tertiary institutions (p>0.05).
conclusionsThis study showed a positive effect of the DRG policy in Wenzhou, even during COVID-19. The policy can motivate public general hospitals to improve their comprehensive capacity and mitigate discrepancies in treatment expenses efficiency for similar diseases. Policymakers are interested in whether the reform successfully motivates hospitals to strengthen their internal impetus and improve their performance, and this is supported by this study.
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