Observational studyBMJ open2025
Associations of Chinese diagnosis-related group system with low-value coronary revascularisation: an interrupted time series analysis.
Observational study in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- The differential impact of Diagnosis-Related Groups (DRG) on hierarchical hospitals: an interrupted time series analysis on health expenditure structure.BMC health services research · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study aimed to investigate whether the Chinese diagnosis-related group (C-DRG) payment system would reduce low-value coronary revascularisation services among coronary heart disease (CHD) inpatients without affecting high-value coronary revascularisation services.
designRetrospective observational study.
settingRoutinely collected claims data from a health insurance database including all inpatients in 22 public hospitals in Sanming, Southern China.
participantsAll patients with CHD are admitted to public hospitals from 1 January 2017 through 31 December 2020. INTERVENTION/EXPOSURE: The implementation of the C-DRG-based payment system on 1 January 2018.
main outcome measuresUsing a health insurance database, we identified two cohorts: beneficiaries for whom the value of coronary revascularisation is lower (those with ischaemic heart disease without acute myocardial infarction, unstable angina and congestive heart failure during hospitalisation) and beneficiaries for whom its value is higher (those with acute coronary syndrome). Then, the rates of low-value or high-value coronary revascularisation were compared before and after the implementation of C-DRG policy, including the use of an interrupted time series analysis.
resultsAn interrupted time series analysis demonstrated that the C-DRG policy was associated with a statistically significant immediate decrease in the rate of low-value coronary revascularisation of -9.78% (95% CI: -11.08% to -8.48%). Further, after introducing C-DRG, the rate of low-value coronary revascularisation decreased by -0.59% (95% CI: -0.88% to -0.30%) every quarter compared with before C-DRG. In addition, after C-DRG, the rate of high-value coronary revascularisation increased by 1.27% (95% CI: 0.14% to 2.41%) every quarter compared with before C-DRG.
conclusionsThis study suggested that C-DRG policy achieved at least short-term success in reducing use of low-value coronary revascularisation without evidence of decreasing high-value coronary revascularisation services. These results can support policymakers in reducing low-value care in China and other countries that use similar systems.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.