Effect Analysis of CHS-DRG Payment Reform on Hospitalization Costs and Related Influencing Factors in Patients Undergoing Coronary Stent Surgery
Objectives This study aims to analyze the changes in hospitalization costs and influencing factors of patients undergoing coronary stent surgery in a tertiary hospital in Beijing before and after the formal payment reform of CHS-DRG and evaluate the implementation effect of the reform.Methods Literature analysis was used to screen out the influencing factors of hospital costs.Retrospective analysis and interruption time series analysis were conducted on the relevant information of 3228 patients undergoing coronary stent implantation surgery from January 1,2020-December 31,2022.Results After the CHS-DRG payment reform,the proportion of patients admitted to emergency departments decreased by 18.95％.The proportion of patients with angina pectoris increases by 14.54％,while the proportion of patients with acute myocardial infarction decreases by 14.79％.The upper quartile,median,and lower quartile of patient hospitalization days all decreased by 1 day.The upper quartile,median,and lower quartile of consumable costs were 29259.02 yuan,19354.33 yuan,and 39839.22 yuan lower than before the reform respectively.The upper quartile,median,and lower quartile of the average cost per case dropped by 27654.7,17834.3,and 40569.2 yuan respectively compared with before the reform,and the differences were statistically significant(P＜0.05).Interrupted time series analysis showed that when CHS-DRG payment was implemented,the average cost of hospitalization decreased by 26 697.2 yuan,the average cost of consumables decreased by 27 922.8 yuan,the average length of stay was shortened by 1.32 days,and the proportions of acute myocardial infarction and angina pectoris also experienced changes in levels and trends during and after the reform.The trend changes before and after the reform were statistically significant(P＜0.05).After the reform,the proportion of material fees dropped most significantly,from 76.33％in 2020 to 53.33％in 2022.The proportion of surgical treatment fees increased significantly,from 9.68％before the reform to 25.5％in 2022.Conclusions The CHS-DRG payment reform has effectively reduced the consumption of medical resources,adjusted the disease structure and expense structure,and promoted hospitals to continue to control costs and reduce expenses on the basis of ensuring medical quality.
CHS-DRGReform of the medical insurance payment systemCoronary-stentHospital costsInterrupt time series
NETL
NSTL
万方数据
