ArticleBMC health services research2026
Impact of day-surgery on cancer treatment costs: a city-level case study in Ningxia, China.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAiming to reduce hospitalization expenses through shorter stays and improved resource allocation, China’s national day surgery cancer treatment reforms were implemented by local health authorities. This study evaluates the impact of the day-surgery management model implemented in Ningxia in 2019 on cancer hospitalization costs, including treatment, comprehensive, diagnostic, consumption, and medicine costs.
methodsFrom January 2015 to December 2022, this retrospective study analyzed data on cancer hospitalization costs from municipal hospitals in Yinchuan, Ningxia. Data on 122,252 patients were collected, excluding deceased patients, incomplete records, and waived costs. Patient data included sex, age, occupation, payment method, admission date, clinical condition, and hospitalization costs. Statistical analysis used STATA, with χ² tests and Fisher’s exact tests comparing patient characteristics pre- and post-implementation of the day-surgery model. A sharp regression discontinuity design (RDD) assessed the model’s impact, dividing observations into pre- (2015–2018) and post-implementation (2019–2022) phases. A sensitivity analysis controlling for length of stay (LOS) was conducted to verify our cancer hospitalization costs changes.
resultsRDD analysis showed that the day-surgery model had no significant impact on total hospitalization costs (p = 0.084). Nevertheless, it was associated with significant reductions in several cost components, significant reductions occurred in comprehensive fees (-RMB293.85), diagnostic fees (-RMB508.3), consumption fees (-RMB386.38), and medicine fees (-RMB1569.5), while treatment fees rose by 46.2%. Crucially, the sensitivity analysis revealed that when controlling for LOS, the total hospitalization cost shifted to a significant increase (+ RMB564.7), and the surge in treatment fees intensified (+ RMB1614.2). This confirms that apparent aggregate cost neutrality masks underlying shifts in cost structure, with savings largely mediated by shorter stays that offset higher daily treatment intensity under the day-surgery model. Diagnostic and comprehensive fee reductions showed time-specific responsiveness, while medicine costs fluctuated at non-policy nodes.
conclusionThe day-surgery model in Ningxia did not significantly reduce aggregate hospitalization costs, with the lower diagnostic, medicine, consumption and comprehensive fee categories offset by increased treatment costs. These results underscore the complexity of day-surgery economics: efficiency gains from faster turnover were partially offset by technology-driven cost escalations. Simply “improving efficiency” is insufficient, with policymakers and hospitals encouraged to enhance the financial sustainability of day-surgery reforms by targeted treatment cost-containment strategies.
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