Medical Expenses for Hospitalized Patients with Cervical Cancer Before and After the Implementation of the DRG Payment Policy

Objective To analyze the cost changes of cervical cancer inpatients after the implementationof diagnosis related group (DRG) payment in public grade-A tertiary hospitals, and to provide reference for public hospitals to improve management strategies and optimize the utilization of medical insurance funds.

Methods Case data of cervical cancer patients discharged from a public grade-A tertiary hospital in Shandong Province from April to December 2021 (before the implementation of DRG) and from April to December 2022 (after the implementation of DRG) were retrospectively collected. Patients with medical insurance were treated as the policy group and patients with full self-payment were treated as the control group. The changes in the relevant indicators such as total hospitalization costs, drug costs and consumable costs of cervical cancer patients before and after the implementation of the DRG policy were analyzed using the double difference-in-difference (DID) method.

Results A total of 10 383 hospitalized patients with cervical cancer were enrolled in this study, including 9711 cases in the policy group (including 5418 cases before the implementation of DRG and 4293 cases after the implementation of DRG) and 672 cases in the control group (including 426 cases before the implementation of DRG and 246 cases after the implementation of DRG). Compared with the pre-DRG policy implementation, there were no significant changes in the complication rate, mortality rate, unplanned rehospitalization rate within 30 days, and length of hospital stay between the patients in the policy group and the control group after the DRG policy implementation. However, the total cost of the policy group decreased from ￥11 453.49 to ￥8780.94 (a decrease of 23.33%), in which the cost of medicines decreased by ￥617.37 (a decrease of 25.17%), and the cost of consumables decreased by ￥28.93(a decrease of 28.49%). The results of the double DID mode showed that the total cost of hospitalization in the policy group decreased by 14.40%(R²=0.616, P < 0.05), the cost of medicines decreased by 13.80%(R²=0.364, P < 0.01), and the cost of consumables decreased by 15.40%(R²=0.565, P < 0.01) compared to the control group after the implementation of the DRG policy.

Conclusions The implementation of DRG policy can reasonably reduce the cost of disease groups and achieve more effective utilization of medical resources on the basis of ensuring accurate clinical diagnosis and high treatment standards.