ArticleFrontiers in public health2025
Impacts of DRG point-based payment system on healthcare resource utilization and provider behavior: a pilot quasi-experimental study 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 6 papers.
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Who cites it
6 citing papers in PubMed.
- Temporal Associations and Heterogeneity of Diagnosis-Related Group (DRG) Payment Reform with Hospitalization Costs Among Patients with Colorectal Cancer in China.Healthcare (Basel, Switzerland) · 2026Article
- Financing Regimes and Case-Mix Complexity in Psychiatric Hospitals Beyond the Pandemic Shock-Insights from a Regional European Healthcare System.Healthcare (Basel, Switzerland) · 2026Article
- Beyond average costs: large-scale evidence on DRG payment reform and the distribution of standardized inpatient spending in China.Health economics review · 2026Article
- Do non-local hospitalized patients cost more? A comparative study based on the implementation of the DRG payment.Frontiers in public health · 2026Article
- DRG-based payment and governance in high-complexity thoracic surgery: implications for efficiency and care delivery.Frontiers in health services · 2026Article
- Impact of DRG payment reform on revenue and expenditure structure of public hospitals in China: evidence from difference-in-differences analysis.Frontiers in public health · 2025Article
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3 authors.
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Abstract
Background: Developing countries commonly face challenges regarding budget constraints and inadequate cost-accounting capabilities during the implementation of a Diagnosis-Related Group (DRG) payment system. China has initiated pilot reforms of the Diagnosis-Related Group point-based payment system (DRG-PBPS) in 40 cities. DRG-PBPS, using historical cost data, integrates global budgeting with case-based point-weighted payments. In this study, its impact on inpatient resource utilization is evaluated and potential strategic behaviors of healthcare providers are examined. Methods: Using administrative data from 15,744 inpatient records of cerebral infarction cases from January 2018 to December 2022 in a Chinese city, this study uses a difference-in-differences (DID) approach to evaluate the effects of the DRG-PBPS reform on hospitalization costs and length of stay. Both the changes in the Charlson Comorbidity Index (CCI) score and 14-day, 30-day, and 90-day readmission rates between the reform and control groups were compared before and after implementation to assess whether providers were involved in patient selection and premature discharge. Results: After DRG-PBPS implementation, hospitalization costs decreased by 9.7% ( Conclusion: The implementation of DRG-PBPS significantly reduced inpatient resource utilization without inducing adverse provider behavior. China's pilot practice illustrates that the DRG-PBPS serves as an effective alternative to the fee-for-service model. For developing countries with constrained budgets and underdeveloped cost-accounting systems, DRG-PBPS provides a feasible strategy for adopting DRG-based payment systems in inpatient care.
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