基于双重差分法的CHS-DRG支付方式改革对肿瘤医院住院费用影响评估  

Assessment of the Impact of CHS-DRG Payment Reform on Hospitalization Costs in a Cancer Hospital Based on the Difference-in-Differences Method

作　　者：高明 刘忆 冷家骅 Gao Ming;Liu Yi;Leng Jiahua(Peking University Cancer Hospital,Beijing,100142,China;不详)

机构地区：[1]北京大学肿瘤医院,北京100142

出　　处：《中国医院管理》2025年第3期78-82,共5页Chinese Hospital Management

摘　　要：目的旨在评估北京市国家医疗保障疾病诊断相关分组(CHS-DRG)实际付费改革对某肿瘤医院住院费用的整体影响。研究专注于改革对外科病组、内科病组、操作病组费用的不同影响,并分析改革政策影响效应随时间的变化趋势。方法利用北京某肿瘤专科医院的住院病案数据,以疾病诊断相关分组(DRG)实际付费人群作为干预组,以非DRG实际付费人群作为对照组,采用双重差分法评估次均住院费用的净效应。通过事件研究图展示了干预前后各个时间点上处理效应的估计值,揭示了干预效应如何随时间而变化。结果CHS-DRG支付方式改革导致干预组次均住院费用(-518.82元)明显变化,特别是外科病组(-3071.72元)、内科病组(-370.10元)。然而,操作病组的费用影响不明显。改革效应随时间表现出减弱趋势。结论改革在初期有效降低了肿瘤专科医院在外科和内科病组方面的住院费用。改革效应的减弱趋势提示应进一步探讨制度改革的长期影响,并优化内部管理以巩固政策成果。Objective It aims to evaluate the overall impact of the CHS-DRG payment reform on hospitalization costs at a designated cancer hospital in Beijing.The research focuses on the differential effects of the reform on the costs of surgical,medical,and procedural care groups,and analyzes the trend of the reform’s impact over time.Methods Utilizing inpatient case data from a specialized cancer hospital in Beijing,it employs the Difference-in-Differences method to assess the net effect on average hospitalization costs,with the DRG payment population as the intervention group and the non-DRG payment population as the control group.Event Study Plots are used to illustrate the estimated treatment effects at various time points before and after the intervention,revealing how the intervention effects change over time.Results The CHS-DRG reform led to a significant change in the average hospitalization costs for the intervention group(-518.82 RMB),particularly in the surgical(-3071.72 RMB)and medical(-370.10 RMB)care groups.However,the impact on procedural care group costs was not significant.The effect of the reform showed a diminishing trend over time.Conclusion The reform effectively reduced hospitalization costs in the specialized cancer hospital,especially within the surgical and medical care groups,during its initial phase.The diminishing trend of the reform’s effect indicates the need for further investigation into the long-term impacts of the system reform and optimization of internal management to consolidate the policy outcomes.

关 键 词：疾病诊断相关分组 住院费用 肿瘤医院 双重差分法 

分 类 号：R197.1[医药卫生—卫生事业管理]