| Autor: |
Tingting Zhu, Xinxin Zhang, Chun Chen, Xiangyang Zhang, Yin Dong, Qingren Yang, Yipao Hu, Ruoyun Liu |
| Jazyk: |
angličtina |
| Rok vydání: |
2024 |
| Předmět: |
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| Zdroj: |
BMJ Open, Vol 14, Iss 3 (2024) |
| Druh dokumentu: |
article |
| ISSN: |
2044-6055 |
| DOI: |
10.1136/bmjopen-2023-073913 |
| Popis: |
Objectives This study measures the differences in inpatient performance after a points-counting payment policy based on diagnosis-related group (DRG) was implemented. The point value is dynamic; its change depends on the annual DRGs’ cost settlements and points of the current year, which are calculated at the beginning of the following year.Design A longitudinal study using a robust multiple interrupted time series model to evaluate service performance following policy implementation.Setting Twenty-two public general hospitals (8 tertiary institutions and 14 secondary institutions) in Wenzhou, China.Intervention The intervention was implemented in January 2020.Outcome measures The indicators were case mix index (CMI), cost per hospitalisation (CPH), average length of stay (ALOS), cost efficiency index (CEI) and time efficiency index (TEI). The study employed the means of these indicators.Results The impact of COVID-19, which reached Zhejiang Province at the end of January 2020, was temporary given rapid containment following strict control measures. After the intervention, except for the ALOS mean, the change-points for the other outcomes (p0.05), the uptrend of the CEI mean in tertiary institutions alleviated (p0.05).Conclusions This study showed a positive effect of the DRG policy in Wenzhou, even during COVID-19. The policy can motivate public general hospitals to improve their comprehensive capacity and mitigate discrepancies in treatment expenses efficiency for similar diseases. Policymakers are interested in whether the reform successfully motivates hospitals to strengthen their internal impetus and improve their performance, and this is supported by this study. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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