在中国DRG支付改革下的医疗费用趋势分析
Li Du1, Shu Fang2, Qilin Zhang3
1School of Political Science and Public Management, Wuhan University, Wuhan, 430072, China.
Scientific reports
|October 22, 2025
概括
诊断相关组 (DRG) 支付改革降低了住院费用,但增加了患者自付费用. 未来的改革应该集中在优化保险效率和降低共同支付,以确保金融可持续性.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健政策 医疗保健政策
- 公共卫生 公共卫生
背景情况:
- 诊断相关小组 (DRG) 支付改革是影响医疗保健成本的重大政策转变.
- 现有的研究还没有完全解决DRG改革的成本控制效率和动态趋势.
- 了解对患者和医疗保健系统的财务影响至关重要.
研究的目的:
- 评估DRG支付改革对住院医疗费用的成本控制有效性.
- 分析改革后支出,保险赔偿和患者自付费用的动态趋势.
- 在DRG实施下,识别住院护理成本结构的变化.
主要方法:
- 曼-惠特尼U测试用于比较改革前和改革后的数据.
- 结构变化分析,以评估成本组成的变化.
- 间断时间序列分析以评估支出轨迹和改革影响.
主要成果:
- 人均住院费用减少了每月713.93元 (p < 0.001).
- 每月的医疗保险支付下降了0.82% (p < 0.01),而自付费用增加了0.82% (p < 0.01).
- 住院费用结构转移了4.37%,药品,卫生材料和实验室成本下降,但检查成本增加 (p < 0.01).
结论:
- 医疗补助支付改革在降低整体住院费用方面取得了部分成功,但加剧了患者的财务负担.
- 药品和卫生材料仍然是重要的成本驱动因素,而医疗服务费用被低估了.
- 未来的政策调整应该旨在承认临床专业知识,提高保险基金的效率,减少患者的共同支付,以确保可持续和负担得起的医疗保健.
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