Full
Outline
To analyze the impact of DRG policy on the medical cost and service efficiency of patients with esophageal cancer, and to provide reference for further improvement of medical services.
Case data of patients with esophageal cancer treated by surgery in five pilot hospitals undergoing DRG policy in Changzhi, Shanxi Province, were collected from January 2019 to June 2023 to analyze the changes in patients' medical costs and hospitalization days before and after the implementation of DRG, and an interrupted time series (ITS) model was established to analyze the impact of the DRG reform.
ITS results indicate that compared to the period before the implementation of the DRG policy, medical expenses for esophageal cancer patients decreased by 12 089 CNY (P<0.05). The intervention instantaneous intercept showed a significant decline and exhibited a sustained downward trend (P<0.05). Hospitalization days decreased by 5 days (P<0.05), with the intervention instantaneous intercept decreasing, though the long-term downward trend was not significant (P=0.176). Within the medical cost structure, the intervention instantaneous intercepts for general medical service fees, diagnostic examination fees, non-surgical treatment fees, surgical fees, and Western medicine fees all decreased. Diagnostic examination fees, non-surgical treatment fees, and Western medicine fees exhibited a long-term downward trend (P<0.05). Conversely, the intervention-specific intercepts for nursing fees, anesthesia fees, and consumables fees all increased, with consumables fees showing the most significant rise. After the reform, consumables fees increased by 9 185 CNY (P<0.05) and exhibited a long-term upward trend (P<0.05).
The DRG policy can alleviate patients' financial burden and enhance the service efficiency of healthcare institutions. It is recommended to further deepen the long-term mechanism of DRG in controlling overall costs and innovate clinical management models; strengthen the supervision of pharmaceuticals and medical consumables; elevate the value of labour and technical services; advance payment method reforms; and improve supporting systems compatible with DRG reform.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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