ArticleFrontiers in public health2025
DRG payment does not predispose to negative clinical outcomes in general surgery cases: evidence from a tertiary hospital in China.
Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- 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
- The impact of unplanned reoperation on clinical and economic outcomes among hospitalized surgical patients: a DRG-adjusted real-world retrospective cohort study.BMC health services research · 2026Article
- DRG-based payment and governance in high-complexity thoracic surgery: implications for efficiency and care delivery.Frontiers in health services · 2026Article
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Authors and funding
7 authors.
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Abstract
Background: Diagnosis-related group (DRG) payment has proven effective in improving efficiency and containing medical costs. However, concerns persist regarding its potential negative impact on healthcare quality. This study aimed to investigate the association of DRG payment with negative clinical outcomes in general surgery cases. Methods: The study utilized clinical and insurance data from patients undergoing elective general surgeries at authors' institution between March 2019 and February 2025, with the DRG payment officially implemented in March 2022. Changes in average costs and length of stay (LOS) before and after the DRG payment were assessed using Results: The sample included 38,014 discharged cases, including 18,666 cases before and 19,348 cases after DRG implementation. Five groups with the highest case volumes were KD1 (thyroid surgery), GB2 (major operation of intestines and colorectum), HC2 (cholecystectomy), GB1 (major operation of stomach and duodenum), HB1 (major operation of pancreas and liver). Following DRG payment, significant reduction in costs was observed in GB2 and GB1, while significant reduction in LOS was observed in groups GB2, HC2 and HB1. ITSA revealed no significant changes in level or trend for any of the five negative clinical outcomes, either in the overall sample or in the subgroups. Conclusion: For patients undergoing general surgeries, DRG payment promoted efficiency without increasing the risk of negative clinical outcomes.
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