Evidence mapPaperPMID 42116151Full record

ArticleBMC health services research2026

Impact of diagnosis-intervention packet payment reform on pediatric hospital services: an interrupted time series analysis.

Ying Liu, Jianghui Zhang, Xiangliang Zhang, Jieling Wu, Wen Chen

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Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Ying Liu *Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, #74 Zhongshan Road 2, Guangzhou, 510080, China.
Jianghui Zhang *Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, #74 Zhongshan Road 2, Guangzhou, 510080, China.
Xiangliang ZhangDepartment of Earth System Science, Tsinghua University, Beijing, 100084, China.
Jieling WuDepartment of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou, 511400, China.
Wen ChenDepartment of Medical Statistics, School of Public Health, Sun Yat-Sen University, #74 Zhongshan Road 2, Guangzhou, 510080, China. chenw43@mail.sysu.edu.cn.

Funding

Natural Science Foundation of China 82473731
6 · The paper itself

Abstract

backgroundDiagnosis-Intervention Packet (DIP) reform has been widely implemented in China, but its impact in pediatric settings remains unclear. This study evaluated its effects on pediatric admissions, case severity, efficiency, and expenditures in a tertiary maternal and child hospital in Guangzhou.

methodsPediatric inpatient discharge data (0-18 years) from January 2016 to December 2019 were analyzed using an interrupted time series design. Outcomes included total admissions, proportion and number of complex/critical and non-local complex/critical cases, mean length of stay (LOS), and mean total expenditure per case. Subgroup analyses by major disease categories and sensitivity analyses were performed to assess the robustness and heterogeneity of reform effects.

resultsA total of 93,396 pediatric discharges were included, with 45,493 discharges in the pre-reform period and 47,903 in the post-reform period. The DIP reform was associated with significant long-term changes in pediatric service utilization and expenditure. Specifically, the monthly slope of total pediatric admissions decreased slightly after the reform (β = -0.006, P < 0.001). Similar decreasing trends were observed for the proportion of complex/critical cases per month (β = -0.018, P < 0.001), the absolute number of complex/critical cases (β = -0.017, P < 0.001), the proportion of non-local complex/critical cases (β = -0.012, P < 0.001), and the absolute number of non-local complex/critical cases (β = -0.016, P < 0.001). In terms of service efficiency, the post-reform monthly slope of mean LOS showed a reduction after accounting for lag periods, whereas mean total expenditures per case showed a statistically significant decrease (β = -0.010, P = 0.001).

conclusionsThe DIP payment reform was associated with decreases in total pediatric admissions, as well as in the proportion and number of complex/critical and non-local complex/critical cases. Mean LOS showed a delayed decrease following the reform, while per-case total expenditures showed a decreasing trend over time.

Indexed as

Health Care ReformHospitals, PediatricAdolescentChildChild, PreschoolChinaFemaleHealth ExpendituresHumansInfantInfant, NewbornInterrupted Time Series AnalysisLength of StayDiagnosis-intervention packetHealthcare reformInterrupted time series analysisPediatric hospital

Identifiers

PMID42116151
PMCPMC13220595

What Socratic holds

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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.