Juanjuan Liang, Yuanqing Cai, Rong Fan, Yuwei Zhang, Yangyi Hu, Wenjuan Wang
The hospitalization expenditure structure was optimized after the reforms, and the price of surgical services increased after the MCL reforms. The patients' cost burden was reduced, and the LOS for patients declined after the reforms. This study provides evidence and reference points for comparing hospitalization expenditures and the LOS for patients in optimizing DRG programs in China and other countries with similar hospitalization systems.
PURPOSE: Hysterectomy and adnexectomy for carcinoma in situ and nonmalignant lesions (HAC) is a subgroup of the diagnosis-related groups (DRG). A comprehensive set of reforms in Beijing, referred to as the medicine-consumables linkage (MCL) reforms, is intended to improve the quality of medical services. This study aims to analyze the impact of the MCL reforms on the changes in hospitalization expenditures, out-of-pocket (OOP) expenditures, and length of stay (LOS) for patients underwent HAC.
METHODS: We used an interrupted time series (ITS) model along with relevant data on HAC from January 2017 to December 2020 to analyze changes in hospitalization expenditures, OOP expenditures, and LOS for patients before and after the MCL reforms were implemented.
RESULTS: The results showed that after the reforms average surgical expenditures per hospitalization increased by 75.34%, whereas average examination and medical consumable expenditures per hospitalization decreased by 17.51% and 12.63%, respectively. The proportion of OOP expenditures decreased by 14.26%, and the average LOS per hospitalization decreased by 21.86%. The ITS analysis showed that the average total, laboratory test, drug, and OOP expenditures per hospitalization decreased monthly after the reforms. The impact of the reforms on the subgroup without comorbidity and complications was even more significant and reached the expected goals of the reforms.
CONCLUSION: The hospitalization expenditure structure was optimized after the reforms, and the price of surgical services increased after the MCL reforms. The patients' cost burden was reduced, and the LOS for patients declined after the reforms. This study provides evidence and reference points for comparing hospitalization expenditures and the LOS for patients in optimizing DRG programs in China and other countries with similar hospitalization systems.