Outcome appraisal of the payment reform of public hospitals in Sanming

Abstract

Objective To evaluate the outcomes of the payment reform at public hospitals in Sanming city. Methods Interrupted time series analysis was used to compare changes of the average days of stay, per capita hospitalization expense, outpatient expense per visit, proportion of medical expense and that of drugs during hospitalization at 21 public hospitals at or above county level before and after the DRGs reform. Results Comparisons before and after the reform found the average days of stay at the original momentum, poor control in curbing the proportion of medical expense and that of drugs during hospitalization, a dropping followed by rising trend in the outpatient expense per visit, and minimal drop of the abovementioned proportions. Conclusions The rapid growth of outpatient and hospitalization costs at tertiary hospitals may be incurred by unreasonable cost transfer, structural trend of hospitalization expense makeup, and rationality pending scrutiny. Key words: Sanming; Payment reform; Diagnosis related groups; Outcome evaluation; Interrupted time series analysis