Evaluation of the Impact of DRG Reform on Hospitalization Costs Based on Synthetic Control Method: An Empirical Study in Beijing Tertiary Public Hospitals

Corresponding author: zhangyuwei, cufeyw2019@163.com

DOI: 10.12201/bmr.202404.00024

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  Abstract: Objective: To analyze effects of Diagnosis-Related Group (DRG) both in short-term and long-term on total hospitalization costs in tertiary public hospitals in Beijing, including growth rate and internal structure. Methods: This article is based on annual statistical report data of hospitalization costs in tertiary public hospitals in Beijing from 2009 to 2018. A synthetic control method was used to analyze the impact of DRG on the total costs and percentage of each cost. Results: Compared to hospitals that did not pilot, in the short term, the pilot hospitals have seen a reduction in the total cost of inpatients and a significant reduction in the drug cost ratio. The growth rate of the consumables costs ratio decreased significantly. The surgery, treatment, and care costs ratio declined while the examination and laboratory costs ratio increased. In long term, the total cost and growth of pilot hospitals exceeds that of non-pilot hospitals. Drug ratio and surgery, treatment, and care costs ratio remain lower than non-pilot hospitals. The consumables costs ratio has increased significantly. Changes in the examination and laboratory costs show strong individual variability. Conclusion: The DRG has a positive effect on controlling growth of total costs in short-term, long-term effects need to be improved and the cost structure need to be optimized. Next stage, DRG should be improved in three ways: fulfill the multifaceted role of the Twin Centers, integrate with performance appraisal of tertiary public hospitals, increase income reflecting the value of doctors skilled labor.

  Key words: Diagnosis-Related Groups; Tertiary public hospitals; Hospitalization costs; Synthetic control method

  Submit time: 16 April 2024

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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