ArticlePloS one2025
The impact of diagnosis-related groups on medical costs, service efficiency, and healthcare quality in Meishan, China: An interrupted time series analysis.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Temporal Patterns in Hospital Performance Indicators in the Chilean Public Hospital System: A Longitudinal Analysis Using Dimensionless Coefficients.Healthcare (Basel, Switzerland) · 2026Article
- Diagnostic coding combination patterns, CHS-DRG severity stratification, and hospitalization expenditure in pneumonia with coexisting hypertension or diabetes mellitus: a single-center cautionary case study of definitional circularity.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
- CHS-DRG 2.0 and insurance-specific patient cost sharing in gestational diabetes admissions: a regression discontinuity in time study.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
- The impact of a deep vertical medical alliance on enhancing clinical capacity and reversing patient outflow at a Chinese county hospital: a 4-year case study.Frontiers in health services · 2025Article
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5 authors.
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Abstract
backgroundIn January 2019, the Diagnosis-Related Groups (DRG) payment system was introduced in Meishan, China. Using the medical insurance records from 2017 to 2022, we evaluated the impact of the DRG system on medical costs, service efficiency and healthcare quality.
methodsThe sample was divided into three periods: Before DRG reform (2017-2018), the first period of DRG reform (2019-2020), and the second period of DRG reform (2021-2022). We employed an Interrupted Time Series (ITS) model to analyze the monthly changes in total hospital costs, patient cost-sharing, patient sharing ratio, length of stay, and 30-day readmission rate during both periods of DRG reform.
resultsIn the first period of DRG reform, total hospital costs decreased by 1.23% per month (95% CI, 0.88%-1.59%), patient cost-sharing decreased by 1.46% per month (95% CI, 1.09%-1.83%), patient sharing ratio decreased by 0.23% per month (95% CI, 0.06%-0.40%), and length of stay decreased by 0.56% per month (95% CI, 0.27%-0.84%). The monthly change in 30-day readmission rate was not statistically significant (-0.11%, 95% CI, -0.73%-0.50%). In the second period of DRG reform, all monthly changes were not statistically significant.
conclusionsThis study assessed the impact of the DRG payment system on medical costs and service efficiency. The results showed that DRG reduced total hospital costs, patient cost-sharing, patient sharing ratio, and length of stay, but did not significantly affect the rising 30-day readmission rates. Over time, the impact of DRG on cost control and service efficiency stabilized. However, unintended hospital behaviors may have emerged, warranting further investigation. The findings suggest that policymakers should strengthen clinical practice regulation, improve the DRG payment system, and continuously monitor healthcare quality trends.
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