ArticlePloS one2025
The impact of diagnosis-intervention packet (DIP) payment on cost structure of inpatient care-Evidence from a tertiary hospital in China.
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 9 papers.
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Who cites it
9 citing papers in PubMed.
- Evaluating the Effect of Diagnosis-Intervention Packet (DIP) Reform in China on Hospitalization Outcomes for Patients with Chronic Obstructive Pulmonary Disease with Special Reference to M City.Healthcare (Basel, Switzerland) · 2026Article
- From individual burden to social risk pooling: drivers of the declining out-of-pocket health expenditure share in China (2009-2024).International journal for equity in 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
- Discharge health education needs and experiences of patients with skeletal-related events from bone metastases: A qualitative study.PloS one · 2026Article
- High-magnification inpatient cases under DIP payment reform: prevalence, cost burden, and risk factors in an NHC-administered hospital in China.Frontiers in public health · 2026Observational
- Trends and determinants of hospitalization costs for umbilical hernia: a 13-year retrospective analysis from 2012 to 2024.Frontiers in surgery · 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
- 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 digital economy on residents' medical cost: an empirical analysis based on interprovincial data from China.Frontiers in public health · 2025Article
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10 authors.
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Abstract
backgroundSince 2020, China has implemented DIP (Diagnosis-Intervention Packet) payment reform to control medical costs and reduce patient financial burden. The reform was piloted in a representative tertiary public hospital within a provincial DIP pilot city.
methodsThe study used hospital settlement and medication records from January 2019 to June 2023. Interrupted time series analysis (ITSA) and structural change degree (SCD) were applied to evaluate the impact of DIP reform on weekly per capita costs and cost structures for surgical and non-surgical groups. Synergistic effects of health system reforms were also assessed.
resultsFrom January 2019 to June 2023, total costs for surgical and non-surgical groups decreased by 3.42% and 1.25%, respectively. Drug and surgical costs declined significantly (p < 0.05) in both groups, while consumable costs increased significantly (p < 0.05). The growth rate of total costs slowed (surgical group: β3 = -14.10; non-surgical group: β3 = -10.76). Total costs in the non-surgical group showed a decreasing trend post-DIP intervention (β1 + β3 = -3.12). Drug costs (surgical group: β3 = -5.50; non-surgical group: β3 = -4.11) and inspection costs (surgical group: β3 = -3.57; non-surgical group: β3 = -1.73) decreased in both groups. Structural change analysis showed a degree of structural variation (DSV) of 10.34% for the surgical group and 5.60% for the non-surgical group. Contribution rates of structural variation (CSV) indicated significant contributions from consumable costs (CSV = 55.83%) and drug costs (CSV = 36.02%) in the surgical group, and inspection costs (CSV = 48.75%) in the non-surgical group.
conclusionDIP payment reform led to positive outcomes in the cost structure of inpatient care. However, increases in inspection costs and differences in cost structures between groups need further attention. Future efforts should focus on more precise cost management.
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