How does DRG reform affect length of stay and hospitalization costs in traditional Chinese medicine hospitals?—an empirical analysis using interrupted time-series model from two cities in western China

Objectives China is advancing Diagnosis Related Group (DRG)-based health insurance reforms to address rising healthcare costs, with traditional Chinese medicine (TCM) hospitals as a key focus. Evaluating the impact of TCM DRG reforms is crucial for China to leverage its unique medical practices in reducing the economic burden of disease. Methods We collected 535,886 hospitalization records regarding length of stay and hospitalization costs from TCM hospitals in Qingyang City and Tianshui City, Gansu Province, for the period from January 2017 to June 2022 (313,823 from Qingyang and 222,062 from Tianshui). A comparative analysis of the DRG reform’s implementation effects in secondary and tertiary TCM hospitals in Qingyang was conducted using descriptive statistics and two groups interrupted time-series (ITS) model. Results In Qingyang’s secondary TCM hospitals, there were no significant changes in the length of stay and hospitalization costs before the DRG reform ( p > 0.05). However, post-reform, both metrics exhibited a notable increase, averaging 0.02 days and CNY 34.54 per month ( p 0.05), while hospitalization costs exhibited a significant upward trend ( p < 0.05). After the implementation of the DRG reform, both length of stay and hospitalization costs significantly declined, with monthly reductions of 0.06 days and CNY 60.47 ( p < 0.05). Conclusion DRG reform has positively influenced the length of stay and hospitalization costs in TCM hospitals, with tertiary facilities showing better outcomes than secondary ones. To improve the effectiveness of DRG health insurance payment reforms in China, it is essential to enhance the qualifications of medical personnel and advance information technology infrastructure in TCM hospitals. Furthermore, implementing differentiated reforms across TCM hospitals and strengthening the systematic development of health insurance payment structures are critical

China · Health insurance · Medical costs · Medical expenses · Medical insurance · National health insurance · Payment · Traditional Chinese medicine · Complementary and Alternative Medicine Studies · Healthcare Systems and Reforms · Traditional Chinese Medicine Studies

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