The impact of DRG payment reform on inpatient costs for different surgery types: an empirical analysis based on Chinese tertiary hospitals

BackgroundTo evaluate the impact of DRG (Diagnosis-Related Group) payment reform on inpatient costs for four major types of surgery at a tertiary hospital in China, with a focus on its implementation in general surgery, cardiothoracic surgery, neurosurgery, and urology.MethodsBased on inpatient data...

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Main Authors: Mingwei Luo, Hongying Li, Rongyue Li, Yugao Wu, Yuping Lan, Shiwei Xie
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1563204/full
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author Mingwei Luo
Hongying Li
Rongyue Li
Yugao Wu
Yuping Lan
Shiwei Xie
author_facet Mingwei Luo
Hongying Li
Rongyue Li
Yugao Wu
Yuping Lan
Shiwei Xie
author_sort Mingwei Luo
collection DOAJ
description BackgroundTo evaluate the impact of DRG (Diagnosis-Related Group) payment reform on inpatient costs for four major types of surgery at a tertiary hospital in China, with a focus on its implementation in general surgery, cardiothoracic surgery, neurosurgery, and urology.MethodsBased on inpatient data from 2019 to 2023, the study employed Propensity Score Matching (PSM) and Difference-in-Differences (DiD) models to compare inpatient cost differences between the DRG payment group and the non-DRG payment group. Concentration indices were used to assess the consistency of inpatient cost distribution.ResultsThe DRG payment reform significantly reduced the total inpatient costs for surgeries in general surgery, cardiothoracic surgery, neurosurgery, and urology, particularly in terms of drug and material expenses. Additionally, the inpatient cost distribution in the DRG payment group became more concentrated, indicating a significant reduction in the proportion of high-cost cases.ConclusionThe DRG payment reform effectively controlled inpatient costs in Chinese tertiary hospitals, particularly for complex surgical procedures, and improved the efficiency of healthcare resource utilization. This study provides empirical support for the further implementation of DRG payment reform and offers policy recommendations for optimizing China’s healthcare payment system.
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spelling doaj-art-9202766822af4e1dbca61fe98fc833fe2025-08-20T03:07:17ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-06-011310.3389/fpubh.2025.15632041563204The impact of DRG payment reform on inpatient costs for different surgery types: an empirical analysis based on Chinese tertiary hospitalsMingwei Luo0Hongying Li1Rongyue Li2Yugao Wu3Yuping Lan4Shiwei Xie5Department of Medical Records Statistics, Panzhihua Central Hospital, Panzhihua, Sichuan, ChinaDepartment of Medical Records Statistics, Sichuan Provincial People's Hospital, Chengdu, Sichuan, ChinaDepartment of Medical Records Statistics, Panzhihua Central Hospital, Panzhihua, Sichuan, ChinaDepartment of Medical Records Statistics, Panzhihua Central Hospital, Panzhihua, Sichuan, ChinaDepartment of Orthopaedics, Panzhihua Central Hospital, Panzhihua, Sichuan, ChinaDepartment of Orthopaedics, Panzhihua Central Hospital, Panzhihua, Sichuan, ChinaBackgroundTo evaluate the impact of DRG (Diagnosis-Related Group) payment reform on inpatient costs for four major types of surgery at a tertiary hospital in China, with a focus on its implementation in general surgery, cardiothoracic surgery, neurosurgery, and urology.MethodsBased on inpatient data from 2019 to 2023, the study employed Propensity Score Matching (PSM) and Difference-in-Differences (DiD) models to compare inpatient cost differences between the DRG payment group and the non-DRG payment group. Concentration indices were used to assess the consistency of inpatient cost distribution.ResultsThe DRG payment reform significantly reduced the total inpatient costs for surgeries in general surgery, cardiothoracic surgery, neurosurgery, and urology, particularly in terms of drug and material expenses. Additionally, the inpatient cost distribution in the DRG payment group became more concentrated, indicating a significant reduction in the proportion of high-cost cases.ConclusionThe DRG payment reform effectively controlled inpatient costs in Chinese tertiary hospitals, particularly for complex surgical procedures, and improved the efficiency of healthcare resource utilization. This study provides empirical support for the further implementation of DRG payment reform and offers policy recommendations for optimizing China’s healthcare payment system.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1563204/fullDRG payment reformsurgery typesinpatient costsChinese tertiary hospitalsmultivariate regression analysis
spellingShingle Mingwei Luo
Hongying Li
Rongyue Li
Yugao Wu
Yuping Lan
Shiwei Xie
The impact of DRG payment reform on inpatient costs for different surgery types: an empirical analysis based on Chinese tertiary hospitals
Frontiers in Public Health
DRG payment reform
surgery types
inpatient costs
Chinese tertiary hospitals
multivariate regression analysis
title The impact of DRG payment reform on inpatient costs for different surgery types: an empirical analysis based on Chinese tertiary hospitals
title_full The impact of DRG payment reform on inpatient costs for different surgery types: an empirical analysis based on Chinese tertiary hospitals
title_fullStr The impact of DRG payment reform on inpatient costs for different surgery types: an empirical analysis based on Chinese tertiary hospitals
title_full_unstemmed The impact of DRG payment reform on inpatient costs for different surgery types: an empirical analysis based on Chinese tertiary hospitals
title_short The impact of DRG payment reform on inpatient costs for different surgery types: an empirical analysis based on Chinese tertiary hospitals
title_sort impact of drg payment reform on inpatient costs for different surgery types an empirical analysis based on chinese tertiary hospitals
topic DRG payment reform
surgery types
inpatient costs
Chinese tertiary hospitals
multivariate regression analysis
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1563204/full
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