ArticleInternational journal of health policy and management2024
Impact of the Diagnosis-Intervention Packet Payment Reform on Provider Behavior in China: A Controlled Interrupted Time Series Study.
Article in International journal of health policy and management, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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.
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.
Who cites it
15 citing papers in PubMed.
- Impact of diagnosis-intervention packet payment reform on pediatric hospital services: an interrupted time series analysis.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
- 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
- Impact of Diagnosis-Intervention Packet (DIP) Payment Reform on County Hospitals: Evidence from Z City, China.Journal of healthcare leadership · 2026Article
- Transforming long-term post-acute care for the aging population through home infusion therapy in China: an assessment of need and demand (Part 1).Frontiers in public health · 2026Review
- Six Sigma and Statistical Process Control in Clinical Pathway Management: An Evaluation Using Coefficient of Variation, Control Charts, and Process Performance Index.Risk management and healthcare policy · 2026Article
- Selective strategic adaptation and structural trade-offs in a public traditional Chinese medicine hospital under China's national performance appraisal: a longitudinal study.Frontiers in health services · 2026Article
- Rising DIP-weighted case mix, restructuring of cost composition, and expanding settlement deficits under diagnosis-intervention packet payment: evidence from case-level data in a tertiary grade a traditional Chinese medicine hospital in Anhui Province, China, 2022-2024.Frontiers in public health · 2026Article
- Impact of Diagnosis-Intervention Packet Compliance Training on Inpatient Expenditures Under Case-Based Payment Reform: A Quasi-Experimental Study Based on Discharge Records.Journal of multidisciplinary healthcare · 2026Article
- The compatibility of diagnosis-intervention packet with the individualized treatment paradigm of traditional Chinese medicine: an analytical study.Frontiers in public health · 2026Article
- Quantitative evaluation of China's new health insurance payment policy based on the policy modeling consistency (PMC) index model.BMC health services research · 2025Article
- The implementation effect of DIP payment method across different population in Southwest China based on multi-group interrupt time series.Frontiers in public health · 2025Article
- Expanding Outpatient Benefit Package Without Increasing Total Spending: Evidence From Outpatient Benefit Reform for Non-Chronic Disease Patients.Inquiry : a journal of medical care organization, provision and financingArticle
- Healthcare Provision Shifts Under DIP Reform: From Conventional Medicine to Traditional Medicine.Inquiry : a journal of medical care organization, provision and financingArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChina has developed a novel case-based payment method called the DiagnosisIntervention Packet (DIP) to regulate healthcare providers' behavior. G city, a metropolis in southeast China, has shifted its payment policy from fixed rate per admission to DIP under regional global budget since 2018. This study examined the immediate and trend changes in provider behavior after this payment reform.
methodsDischarge data in G city between 2016 and 2019 was used, covering more than 10 million inpatient cases in 320 hospitals. A counterfactual scenario was developed to assign insured and uninsured inpatients across the study period to specific DIP groups under consistent rules. Controlled interrupted time-series (ITS) analyses were performed, with uninsured inpatients as control. Outcomes included inpatient volume, average DIP weight (similar to case-mix index in Diagnosis-Related Groups), and two innovative indicators (average diagnostic weight and average treatment weight) to decompose the changes in DIP weight. Subgroup analyses were conducted for different hospital levels and 21 major disease categories.
resultsAfter the DIP reform, monthly trend of inpatient volume decreased (-1085.34, P=0.052), while monthly growth of average DIP weight increased (2.17, P=0.02). No significant changes in average diagnostic weight were observed. Monthly trend of average treatment weight increased (2.38, P=0.001) after the reform. Secondary and tertiary hospitals experienced insignificantly decreased inpatient volume and elevated average DIP weight, accompanied by negligible change in average diagnostic weight and significant increase in average treatment weight. Primary hospitals experienced reduced inpatient volume and stable average DIP weight, along with increase in average diagnostic weight and decrease in average treatment weight.
conclusionBy differentiated payments for severity, DIP induced hospitals to shift their focus from volume to weight of inpatients. Instead of diagnostic upcoding, hospitals responded to the DIP reform primarily by increasing treatment intensity. Primary hospitals may face financial risks under regional competition.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.