ArticleRisk management and healthcare policy2024
The Impact of a New Case-Based Payment System on Quality of Care: A Difference-in-Differences Analysis in China.
Article in Risk management and healthcare policy, 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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Who cites it
5 citing papers in PubMed.
- An adaptive and interpretable case grouping framework for healthcare payment systems.International journal for equity in health · 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
- Development and validation of dual-time-window readmission prediction models under China's medical insurance multi-payment reform.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
- Interrupted time series analysis of the impact of DIP reform on hospitalization costs in different types of hospitals.Frontiers in public health · 2025Article
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Authors and funding
7 authors.
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Abstract
Purpose: China has developed and widely piloted a new case-based payment, ie, the "Diagnosis-Intervention Packet" (DIP) payment, which has a granular classification system. We evaluated the impact of DIP payment on the quality of care in a large pilot city in China and explored potential mechanisms of quality change. Methods: The city started to implement DIP payment with a hospital-level cap on July 1, 2019. Using a 5% random sample of discharge records from July 2017 to June 2021, we employed a difference-in-differences approach to compare two mortality measures (in-hospital mortality, mortality of surgical patients), two readmission measures (all-cause readmission within 30 days, readmission with the same principal diagnosis within 30 days) and a patient safety measure (operation associated complications or adverse event) in 13 pilot hospitals and 27 non-pilot hospitals before and after DIP payment reform. Results: Of 122,637 discharge records included, 43,023 (35.1%) were from pilot hospitals. After DIP payment, the readmission rate within 30 days and readmission rate with the same principal diagnosis in pilot hospitals decreased significantly by 3.2 percentage points ( Conclusion: This study indicated that DIP payment with a cap in the study city was associated with improved quality of care among patients in pilot hospitals. The provider's behavior of increasing the intensity of care, especially for more severe patients, may partially contribute to the results.
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