Whether Diagnosis-Related Groups will Lead to the shift of Medical Service from Inpatient to Outpatient Settings: an Empirical Study Based on the PSM-DID

Corresponding author: Guo Moning, guomoning@wjw.beijing.gov.cn

DOI: 10.12201/bmr.202501.00047

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  Abstract: Objective To evaluate the changes in medical service utilization following the implementation of DRG payment reform in Beijing. Methods The study collected the home data of inpatient medical records from 15 tertiary general hospitals participating in DRG payment, from April 2021 to October 2022. The data was analyzed before and after the reform, with patients receiving urban employee basic medical insurance as the payment group, and other populations as the control group. A propensity score matching-difference-in-differences model was used to analyze the changes in average length of stay, average cost per hospitalization, and re-outpatient rate before and after the reform. Results The 15 tertiary general hospitals experienced a downward trend in average days of stay and average cost per hospitalization. However, The changes in pre-admission and post-discharge re-outpatient rates were found to be not significant after the implementation of DRG payment. Conclusion The implementation of DRG payment did not result in a transfer of inpatient medical service demand to outpatient service. However, it is important to note that the long-term effect of the reform needs further evaluation.

  Key words: health policy evaluation; DRG payment method; rate of outpatient revisits; PSM-DID

  Submit time: 15 January 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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