Quantitative Analysis of the Effects of DRG/DIP Payment Method Reform——Taking Monitoring Sites and Representative Cities as Examples
Objective:The paper attempts to quantitatively evaluate the impact of DRG/DIP payment method reform on medical service efficiency and medical cost management.Methods:Based on the medical insurance settlement data from four monitoring sites of Handan,Shangrao,Shaoyang and Dongying,as well as comprehensive medical record data from representative cities such as Nanjing,Datong,Anyang and Suqian,descriptive statistical analysis was conducted.Results:In terms of medical service efficiency,the average CMI increased by 0.1,the average length of stay(ALOS)and the CMI-standardized ALOS decreased by 0.7 days and 0.9 days,respectively.Regarding medical cost management,the average hospitalization cost decreased by 3.24%,and the cost structure became more reasonable,with a decrease in the proportion of drug and consumable costs and a gradual increase in the proportion of medical service costs.Medical institutions have achieved an overall balance in medical insurance fund revenue and expenditure,though there were differences among various departments.Conclusion:The DRG/DIP payment method reform has improved both the service efficiency and cost management of medical institutions.It is recommended to strengthen the overall coordination management model of medical institutions under the disease group payment model to improve overall operational efficiency.
medical insurance fundDRG/DIP payment reformmedical service efficiencymedical expense management
NETL
NSTL
万方数据
