Abstract
(1) Background: Undifferentiated function for medical institutes in different levels had been a barrier to China’s healthcare reform. Thus, this study aimed to detect medical services that were capable offered both in tertiary and county hospitals in China and discuss the process of detection. (2) Method: Data of 2 tertiary hospitals that were city level and 12 county-level hospitals from one city in China were collected and grouped into diagnosis-related groups (DRGs). A strategy with four steps was devised by considering the aspects of service volume, in-hospital mortality rate, in-hospital adverse events rate, and inpatient cost. Additionally, a comparison of each indicator was made between city- versus county-level hospitals. (3) Results: There were no differences in service quality between the two levels of hospitals while county hospitals had lower average inpatient costs in 129 DRGs that covered 39.5% of all cases. About CNY 0.26 billion would be saved if certain cases were paid at county-level prices. (4) Conclusion: The study proposed a strategy with four steps that could help in locating the range of diseases in which patients’ admission suffered from the problem of undifferentiation between hospitals’ functions to reduce the irrational growth of healthcare expenditure.
Highlights
No significant differences between city and county hospitals at the diagnosis-related group (DRG) level were found for other postoperative complications
They found that patients who went to the farther hospital for primary care paid extra cost, which is similar to our results
Hamada et al compared the quality, cost, and efficiency of services between patients with DRG-like prospective payment systems and fee-for-services by taking 8 year’s administrative data of AMI patients in Japan as an example, concluding that reform of prospective payment system would be of benefit in reducing healthcare resource consumption, but more discussion is still needed for the effect of service quality [16]
Summary
This study aimed to detect medical services that were capable offered both in tertiary and county hospitals in China and discuss the process of detection. The aim of this study was to locate the diseases that nontertiary hospitals could offer with sufficient quality and lower expenditure and present a strategy of the selection process
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
