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ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Policy
Volume 13 - 2025 |
doi: 10.3389/fpubh.2025.1523067
Impact of DRG policy on the performance of tertiary hospital inpatient services in Chongqing, China: An Interrupted Time Series Study, 2020-2023
Provisionally accepted- 1 Affiliated Banan Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
- 2 College of Medical Information, Chongqing Medical University, Chongqing, China
- 3 department of information, Daping Hospital, Chongqing, China
- 4 Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
Background: Implementing the diagnosis-related groups (DRG) payment policy in 2021 marked a significant step in increasing the capacity and efficiency of public hospital services in Chongqing, China. However, the adaptability and effectiveness of DRG policy in middle-income regions like Chongqing remain understudied. This study evaluates the impact of DRG on tertiary hospital inpatient services in Chongqing, focusing on challenges unique to resource-constrained settings. Methods: Using an interrupted time series design, we analyzed monthly data of 14 DRG performance measures obtained from the DRG comprehensive management system, covering two public hospitals in Chongqing from 2020 to 2023. To evaluate both immediate and long-term effects of the DRG policy, we employed an interrupted time series analysis model to analyze changes in indicator levels and trends pre-and post-intervention. Results: We found significant changes in the following indicators since the implementation of the DRG policy: case-mix index (CMI) level increased by 0.0661 (P = 0.02), but the trend decreased by 0.0071 (P < 0.001). the time efficiency index (TEI) level decreased by 0.123 (P < 0.001), while the trend increased by 0.0106 (P < 0.001). the cost efficiency index (CEI) level decreased by 0.0633 (P = 0.003), with the trend rising by 0.0076 (P < 0.001). and average length of stay (ALOS) trend increased by 0.0609 (P = 0.002). readmission rates (RR) exhibited an instantaneous increase of 0.5653% (P = 0.008) post-intervention, though the long-term trend remained stable (P = 0.598). No significant differences were observed in the changes in inpatient numbers, surgical proportion, bed turnover rate (BTR), mortality rates (DR), cost per hospitalization (CPH), drug cost per
Keywords: DRG, performance evaluation, Service capacity, Service efficiency, Service cost Interrupted time series
Received: 05 Nov 2024; Accepted: 07 Feb 2025.
Copyright: © 2025 Liu, Liao, Tan, Yongjie and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yunyu Liu, Affiliated Banan Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016, China
Zusong Liao, Affiliated Banan Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016, China
Yuting Wang, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
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