Analysis of the impact of DRG payment reform in a hospital based on interrupted time-series
Objective Evaluate the impact of the DRG payment reform of a tertiary general hospital on the medical quality and operation of the hospital,and find a high-quality development path for public hospitals while ensuring the stable and excessive DRG payment reform.Methods Collect the operation data and medical quality data of a tertiary public hospital in Beijing from April 1,2021 to March 31,2023,and define the pre-reform group from April 1,2021 to March 31,2022,and the post-reform group from April 1,2022 to March 31,2023.Use interrupted-time-series to analyze the changes of indicators before and after the reform.Results The DRG payment reform has had a certain impact on hospital operation efficiency and medical quality.The effect of the reform has been initially shown.The number of outpatient and emergency cases has decreased,and the number of daytime surgeries has increased.The difference is statistically significant(P＜0.05)but there is no obvious change.The difference between the average number of hospitalisation days and surgical complications is statistically significant(P＜0.05),but there is no obvious trend of change.The difference in the average cost of hospitalisation,the average cost of hospitalisation,and the proportion of inpatient medical services is statistically significant(P＜0.05),and the average cost of hospitalisation has a significant downward trend(P=0.004).The reform has had a significant effect on reducing hospitalisation costs and adjusted the cost structure.There is no obvious statistical significance and trend of change in the remaining indicators.Conclusion The DRG payment reform has an obvious effect on the control of medical expenses,and at the same time has a certain impact on medical quality management.Hospitals should continue to focus on monitoring the trend of medical quality and efficiency,so as to achieve a double improvement of public welfare and quality efficiency.
DRG payment reformInterrupted Time Series(ITS)AnalysisMedical quality management
NETL
NSTL
万方数据
