PDF(Pubmed)
Abstract：
BACKGROUND: The Diagnosis-Intervention Packet (DIP) payment system, initiated by China\'s National Healthcare Security Administration, is designed to enhance healthcare efficiency and manage rising healthcare costs. This study aims to evaluate the impact of the DIP payment reform on inpatient care in a specialized obstetrics and gynecology hospital, with a focus on its implications for various patient groups.
METHODS: To assess the DIP policy\'s effects, we employed the Difference-in-Differences (DID) approach. This method was used to analyze changes in total hospital costs and Length of Stay (LOS) across different patient groups, particularly within select DIP categories. The study involved a comprehensive examination of the DIP policy\'s influence pre- and post-implementation.
RESULTS: Our findings indicate that the implementation of the DIP policy led to a significant increase in both total costs and LOS for the insured group relative to the self-paying group. The study further identified variations within DIP groups both before and after the reform. In-depth analysis of specific disease groups revealed that the insured group experienced notably higher total costs and LOS compared to the self-paying group.
CONCLUSIONS: The DIP reform has led to several challenges, including upcoding and diagnostic ambiguity, because of the pursuit of higher reimbursements. These findings underscore the necessity for continuous improvement of the DIP payment system to effectively tackle these challenges and optimize healthcare delivery and cost management.
METHODS: To assess the DIP policy\'s effects, we employed the Difference-in-Differences (DID) approach. This method was used to analyze changes in total hospital costs and Length of Stay (LOS) across different patient groups, particularly within select DIP categories. The study involved a comprehensive examination of the DIP policy\'s influence pre- and post-implementation.
RESULTS: Our findings indicate that the implementation of the DIP policy led to a significant increase in both total costs and LOS for the insured group relative to the self-paying group. The study further identified variations within DIP groups both before and after the reform. In-depth analysis of specific disease groups revealed that the insured group experienced notably higher total costs and LOS compared to the self-paying group.
CONCLUSIONS: The DIP reform has led to several challenges, including upcoding and diagnostic ambiguity, because of the pursuit of higher reimbursements. These findings underscore the necessity for continuous improvement of the DIP payment system to effectively tackle these challenges and optimize healthcare delivery and cost management.
摘要：
背景：诊断干预数据包（DIP）支付系统，由中国国家医疗保障局发起，旨在提高医疗保健效率并管理不断上涨的医疗保健成本。这项研究旨在评估DIP支付改革对妇产科专科医院住院护理的影响，重点关注其对各种患者群体的影响。
方法：要评估DIP策略的效果，我们采用了差异差异(DID)方法。该方法用于分析不同患者组的总住院费用和住院时间（LOS）的变化，特别是在选择DIP类别内。该研究涉及对DIP政策实施前后的影响进行全面检查。
结果：我们的发现表明，DIP政策的实施导致相对于自费组，被保险人组的总成本和LOS均显着增加。该研究进一步确定了改革前后DIP组内的差异。对特定疾病组的深入分析显示，与自付组相比，被保险人组的总费用和LOS明显更高。
结论：DIP改革带来了一些挑战，包括上编码和诊断歧义，因为追求更高的报销。这些发现强调了持续改进DIP支付系统的必要性，以便有效应对这些挑战并优化医疗保健服务和成本管理。
方法：要评估DIP策略的效果，我们采用了差异差异(DID)方法。该方法用于分析不同患者组的总住院费用和住院时间（LOS）的变化，特别是在选择DIP类别内。该研究涉及对DIP政策实施前后的影响进行全面检查。
结果：我们的发现表明，DIP政策的实施导致相对于自费组，被保险人组的总成本和LOS均显着增加。该研究进一步确定了改革前后DIP组内的差异。对特定疾病组的深入分析显示，与自付组相比，被保险人组的总费用和LOS明显更高。
结论：DIP改革带来了一些挑战，包括上编码和诊断歧义，因为追求更高的报销。这些发现强调了持续改进DIP支付系统的必要性，以便有效应对这些挑战并优化医疗保健服务和成本管理。
