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The Impact of DRG Review Teams on Obstetric Disease Management and Cost Control: A Variance Analysis Approach
Xia Liang1, Rui Zhang1, Congling Liao2
1Department of Hospital Operations Management, Shenzhen Baoan Women's and Children's Hospital, Shenzhen, Guangdong, China.
Aim:
The global transition toward Diagnosis-Related Groups (DRG) payment systems has fundamentally reshaped hospital reimbursement landscapes, yet obstetric departments present distinctive implementation challenges owing to the dual-patient paradigm and inherent clinical heterogeneity of maternal-fetal medicine. This study investigates whether strategically constituted DRG review teams can optimize both cost containment and care quality in obstetric settings through variance analysis methodology.
Methods:
We conducted a retrospective cohort analysis at Shenzhen Baoan Women's and Children's Hospital spanning June 2022 to June 2025, encompassing 120 obstetric cases stratified across major DRG categories. The analytical framework integrated Time Consumption Index (TCI), Cost Consumption Index (CCI), and Boston Matrix positioning analysis. Primary outcomes included cost variance patterns, length of stay trajectories, and composite quality indicators with statistical adjustment for patient complexity.
Results:
Multidisciplinary DRG review team implementation yielded statistically significant improvements: TCI decreased from 1.15 ± 0.23 to 0.89 ± 0.18 (p < 0.001), representing 22.61% efficiency gains; CCI improved from 1.08 ± 0.21 to 0.91 ± 0.16 (p < 0.001), indicating 15.74% cost reduction. Average length of stay decreased from 6.21 ± 2.34 to 4.73 ± 1.87 days (p < 0.001), with mean cost savings of ¥1333.33 per case. Pharmaceutical expenses demonstrated the strongest correlation with total cost variance (ρ = 0.82, p < 0.001). Critically, quality indicators remained stable throughout implementation, with 30-day readmission rates maintained at 2.50% ± 1.20%.
Conclusions:
Structured multidisciplinary DRG review teams demonstrate substantial effectiveness in optimizing obstetric resource utilization while preserving care quality. Variance analysis provides a robust framework for identifying pharmaceutical cost management as the primary leverage point for system-wide optimization, informing targeted intervention strategies for DRG implementation within specialized obstetric contexts.
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