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To investigate the implementation effects of the DIP payment reform on rehabilitation inpatients, providing empirical support for assessing the applicability of current medical insurance payment reform to rehabilitation inpatients.
An interrupted time series analysis was conducted using data from the discharge summaries of rehabilitation inpatients at a large tertiary public hospital in Chengdu from 2019 to 2023.
A total of 2 143 rehabilitation inpatient cases were included in this study. After the reform, indicators reflecting the operational efficiency of the rehabilitation department showed a positive trend, with the average monthly inpatient visits steadily increasing (β = 0.395, P < 0.001). The average length of stay decreased but not significantly (β < 0, P > 0.05). The treatment costs, reflecting the technical labor value of rehabilitation physicians, significantly decreased (β = -45.251, P < 0.05), while drug costs increased (β = 2.36, P < 0.05). The changes in patient financial burden indicators were minimal, with out-of-pocket expenses showing a slight increase (β = 1.818, P > 0.05).
The results indicate that the DIP payment reform has weak control over the length of stay for rehabilitation patients. After the reform, the out-of-pocket expenses for patients did not decrease, and their medical needs were not adequately met. Future efforts should focus on establishing a patient demand-oriented payment method for rehabilitation medical insurance.
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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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