The effects of the diagnosis-intervention packet payment reform in China
Evidence from Guangzhou
Bibliographic Data
| ID | 22079400 |
|---|---|
| Authors | Yuhao Wang (0009-0008-5833-2418, China Pharmaceutical University), Xiaoqing Huang (0009-0002-3722-0990, China Pharmaceutical University), Nana Lu (Zhongda Hospital Southeast University), Xin Xu (0000-0002-9972-8995, China Pharmaceutical University), Lina Wang (0009-0002-3877-4928, China Pharmaceutical University), Wenwen Du (0000-0002-8288-0181, China Pharmaceutical University, corresponding author), Wei Xu (0000-0002-4727-1540, China Pharmaceutical University, corresponding author) |
| Year | 2025 |
| Volume | 13 |
| Pages | 1633222-1633222 |
| Publication date | 2025-09-05 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Frontiers in Public Health (JOURNAL) |
| Journal identifiers | ISSN: 2296-2565 • E-ISSN: 2296-2565 |
| Publisher | Frontiers Media SA (PUBLISHER • CH) |
| DOI | 10.3389/fpubh.2025.1633222 |
| PMID | 40977807 |
| OpenAlex | W4414027483 |
| Language | EN |
| Citations received | 2 |
| References cited | 29 |
Background: This study evaluated the impact of Guangzhou's Diagnosis-Intervention Packet (DIP) payment reform, introduced as an alternative to the traditional fee-for-service (FFS) model, on inpatient costs, patients' out-of-pocket (OOP) payments, hospital length of stay (LOS) and 30-day readmission rate. Method: We conducted a single-group interrupted time series analysis using monthly data from the Guangzhou Urban Employee Basic Medical Insurance Scheme, spanning January 2017 to June 2020. Outcome indicators included inpatient cost per case, medication expenditures, medical consumables expenditures, diagnostic and therapeutic service expenditures, OOP payments, LOS and 30-day readmission rate. Results: While the DIP reform was associated with a modest reduction in the rate of LOS decline, it did not significantly lower inpatient cost. Instead, total inpatient expenditures exhibited a sustained upward trend in the post-reform period. Moreover, OOP payments per case increased significantly following the reform, indicating a heavier financial burden on patients. Sub-item analysis revealed that medication expenditures declined and stabilized after a pre-policy drop, whereas diagnostic and therapeutic service expenditures continued to grow without evident signs of deceleration. The 30-day readmission rate remained largely stable throughout the study period. Conclusion: The DIP reform in Guangzhou did not achieve its intended goals of reducing inpatient expenditures or alleviating patients' financial burdens. These unintended effects were driven by the incentive structure of the DIP system-particularly its reliance on historical cost data for RW calculation and its reimbursement deduction method-which encouraged hospitals to shift costs and elevate OOP payments. Policymakers should reassess DIP's algorithmic parameters and strengthen cost-accounting transparency to ensure more equitable and efficient medical insurance fund allocation
Business · China · Computer network · Environmental health · Network packet · Payment · Political science · Computer Science · Healthcare Policy and Management · Healthcare Systems and Reforms · Medicine · Nursing · Primary Care and Health Outcomes · Finance
Conducting Interrupted Time-series Analysis for Single- and Multiple-group Comparisons
Use of Interrupted Time Series Analysis in Evaluating Health Care Quality Improvements
Facilitators and barriers to the implementation of DIP payment methodology reform in a public hospital in Guangzhou
Current scenario and challenges of clinical pharmacists to implement pharmaceutical care in DRG/DIP payment hospitals in China
The implementation effect of DIP payment method across different population in Southwest China based on multi-group interrupt time series
Medical Care Costs
| Citations per year | 2 |
|---|---|
| Citation span | 2026 - 2026 (1) |
| Highly cited | No |