ArticleInternational journal for equity in health2025
Impact of diagnosis-related group payment on medical expenditure and treatment efficiency on people with drug-resistant tuberculosis: a quasi-experimental study design.
Article in International journal for equity in health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Financial Feasibility of BPaL(M) Under Pretomanid Price Scenarios - China, 2023-2024.China CDC weekly · 2026Article
- The impact of public hospital performance-based pay scheme reform on revenue structure and service efficiency under the Diagnosis-Intervention Packet payment system: evidence from a pilot city in China.BMC health services research · 2026Article
- Beyond average costs: large-scale evidence on DRG payment reform and the distribution of standardized inpatient spending in China.Health economics review · 2026Article
- The effect of diagnosis-related group policy on treatment cost and treatment efficiency of inpatients with coronary heart disease in Xinjiang: an interrupted time series analysis.Journal of global health · 2026Article
- Impact of risk adjustment for drug-resistant types on tuberculosis patients' outcomes under China's innovative payment methods: a quasi-experimental study design.Infectious diseases of poverty · 2026Article
- Do non-local hospitalized patients cost more? A comparative study based on the implementation of the DRG payment.Frontiers in public health · 2026Article
- A study on the impact of DRG payment reform on hospitalization costs and outcomes of patients with fractures and intervertebral disc herniations.Frontiers in public health · 2026Article
- From midlife emergence to old-age divergence: an empirical study on structural gendered ageism in health service utilization in Tibet.International journal for equity in health · 2025Article
- The impacts of the diagnosis-related group payment reform on hospitalization-related medical expenses: evidence from China.Health economics review · 2025Article
- How DRG Payment Reform Shapes Inpatient Neurological Care in an Underdeveloped Region: Evidence from a Controlled Interrupted Time Series Study in Yunnan, China.Risk management and healthcare policy · 2025Article
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7 authors.
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Abstract
backgroundThe severe health challenge and financial burden of drug-resistant tuberculosis (DR-TB) continues to be an impediment in China and worldwide. This study aimed to explore the impact of Diagnosis-related group (DRG) payment on medical expenditure and treatment efficiency among DR-TB patients.
methodsThis retrospective cohort study included all DR-TB patients from the digitized Hospital Information System (HIS) of Wuhan Pulmonary Hospital and the TB Information Management System (TBIMS) with completed full course of National Tuberculosis Program (NTP) standard treatment in Wuhan from January 2016 to December 2022, excluding patients whose treatment spanned both before and after the DRG timepoint. These patients are all receiving standardized treatment specified by the NTP in designated tuberculosis hospitals. We performed the difference-in-differences (DID) model to investigate 6 primary outcomes. The cost-shifting behaviors were also examined using 4 outpatient and out-of-pocket (OOP) indicators. In the DID model, the baseline period is set from January 2016 to December 2020 before the DRG payment reform, while the treatment period is from January 2021 to December 2022. The payment reform only applied to individuals covered by Wuhan Municipal Medical Insurance, so the treatment group consists of patients insured by this plan, with other patients serving as the control group.
resultsIn this study, 279 patients were included in the analysis, their average treatment duration was 692.79 days. We found the DRG payment implementation could effectively reduce the total medical expenditure, total inpatient expenditure, and inpatient expenditure per hospitalization by 28636.03RMB (P < 0.01), 22035.03 RMB (P < 0.01) and 2448.00 RMB (P < 0.05). We also found a reduction in inpatient frequency and inpatient length of stays per hospitalization by 1.32 and 2.63 days with significance. The spillover effects of the DRG payment on outpatient and OOP expenditure were statistically insignificant.
conclusionsThe DRG payment method can effectively control the increase of DR-TB patients' medical expenditure and improve treatment efficiency with the guarantee of care quality. Furthermore, there was no evidence of spillover effects of DRG payment on outpatient and out-of-pocket expenditures.
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