病院のコストシフトやコスト削減は 補償制度の改革に 対応しているのでしょうか? 中国における診断関連グループ (DRG) 制度
Jiabi Wang1,2, Jinyun Zhu2,3, Kuan Hu1,2
1School of Accounting, Nanfang College, Guangzhou, Guangdong, China.
Frontiers in public health
|September 5, 2025
まとめ
中国の診断関連グループ (DRG) システムの導入は,眼内レンズ (IOL) 植入などの処置の入院費用を効果的に削減し,自費患者へのコストシフトの証拠を示さなかった.
科学分野:
- 健康 経済
- 医療政策
- 医療サービス研究
背景:
- 中国が最近導入した診断関連グループ (DRG) の医療費補償制度は,医療費を患者自給に転嫁させる可能性があることを懸念しています.
- 南市と Ganzhou市は2018年にDRG情報システムを導入し,南市は2019-2020年のパイロット期間中にシステムを完全に採用した.
研究 の 目的:
- 中国の江西省で眼内レンズ (IOL) 移植の入院費用に対するDRGの実施の影響を調査する.
- 具体的にはDRGの採用が 患者の自給自足に 費用のシフトをもたらしたかどうかを評価する.
主な方法:
- 2017年から2020年にかけての14,310人の患者の管理データセットを利用した.
- 病院入院費用を分析するために,量差差分法 (DID) と差分差分法 (DDD) を適用した.
- 眼内レンズ (IOL) 植入の手続きに焦点を当てた分析
主要な成果:
- 南におけるDRGの実施は,平均IOLコスト比率を0.047 (p < 0.001) で大幅に削減し,より高いコストクォンチールでより大きな削減を行った.
- DDDモデルでは,DRGが実施された病院で自己資金提供の患者に対するIOLコスト比率が0.226パーセント低下したと示しています.
- これらの結果は様々な医療費比で 堅調でした
結論:
- 中国の病院のDRGシステムは 医療費を自給自足する患者へと 移行させずに 医療費をうまくコントロールした.
- このシステムは,高コストの異常値を管理する上で特に効果的であることが示され,これはより高いコスト量に及ぼす影響によって証明された.
- 集中医療調達や医療ITなどの統合された要因は,これらのポジティブな結果に寄与する可能性があります.
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