ArticleInternational journal for equity in health2024
Can single disease payment impact hospitalization expenses and quality in district hospital? A case study in Fujian, China.
Article in International journal for equity in health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed.
- Risk Governance of Payment Exceptions Under China's DRG/DIP Reform: A Structured Policy-Text Analysis of Special Case Negotiation Rules.Risk management and healthcare policy · 2026Article
- Clinical and economic impacts of a clinical pathway-based single disease payment policy on hysterectomy for uterine fibroids: a decade-long interrupted time series analysis.Frontiers in public health · 2026Article
- Characteristics and economic burden of hospitalized tuberculosis patients in Guangdong Province, China, from 2017 to 2023: a population-based study.BMC infectious diseases · 2025Article
- Correlation analysis between single disease quality management and efficiency indicators of a tertiary hospital in China.BMC health services research · 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
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Abstract
backgroundChina is exploring payment reform methods for patients to address the escalating issue of increasing medical costs. While most district hospitals were still in the stage of Single Disease Payment (SDP) due to conditions, there is a scarcity of research on comprehensive assessment of SDP. This study aims to evaluate the implementation of SDP in a district hospital, and provided data support and scientific reference for improving SDP method and accelerating medical insurance payment reform at district hospitals.
methodsData was collected from 2337 inpatient medical records at a district hospital in Fuzhou, China from 2016 to 2021. These diagnoses principally included type 2 diabetes, planned cesarean sections, and lacunar infarction. Structural variation analysis was conducted to examine changes in the internal cost structure and dynamic shifts in medical expenses for both the insured (treatment group) and uninsured (control group) patients, pre- and post-implementation of the SDP policy on August 1, 2018. The difference-in-differences (DID) method was employed to assess changes in hospitalization expenses and quality indicators pre- and post-implementation. Furthermore, subjective evaluation of medical quality was enhanced through questionnaire surveys with 181 patients and 138 medical staff members.
resultsThe implementation of SDP decreased the medical expenses decreased significantly (P < 0.05), which can also optimize the cost structure. The drug cost ratio descended significantly, and the proportion of laboratory fee rose slightly. The changes in infection rate, cure rate, and length of stay indicated enhanced medical quality (P < 0.05). The satisfaction of inpatients with SDP was high (89.2%). Medical staff expressed an upper middle level of satisfaction (77.2%) but identified difficulties with the implementation such as "insufficient coverage of disease types".
conclusionAfter the implementation of SDP in district hospitals, considerable progress has been achieved in restraining medical expenses, coupled with notable enhancements in both medical quality and patient satisfaction levels. However, challenges persist regarding cost structure optimization and underutilization of medical resources. This study suggests that district hospitals can expedite insurance payment reform by optimizing drug procurement policies, sharing examination information, and strengthening the management of medical records.
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