摘要

Objective To evaluate the implementation effects of the Diagnosis-Intervention Packet (DIP) policy and analyze its impact on the cost structure and changes in hospitalization expenses. Methods Data on hospitalization costs from two tertiary hospitals in Guizhou Province that implemented the DIP payment reform between December 2018 and October 2023 were collected. Patients were divided into inpatient surgical and non-surgical group s based on their treatment modality. Changes in hospitalization costs before and after policy implementation were analyzed using structural change analysis and breakpoint regression analysis. Results A total of 2070 inpatient surgical cases were analyzed (1012 before policy implementation, 1058 after), and 1317 non-surgical cases (1024 before, 293 after). In terms of cost structure, the structural change value of diagnostic fees decreased from 5.40% before the policy implementation to -1.79% after implementation; the structural change value of Western medicine fees decreased from 2.07% to -3.07%. Both categories of expenses saw a reduction in their proportion of the total costs. In terms of cost changes, both surgical and non-surgical groups experienced an increase in comprehensive medical service costs. The average hospitalization costs in the surgical group remained relatively unchanged, while surgical treatment and consumables fees showed significant decreases. For the non-surgical group, the average hospitalization cost dropped significantly from 33,150.94 Yuan to 17,384.96 Yuan (p<0.05), with significant reductions in diagnostic and Western drug costs. Conclusion After the implementation of the DIP policy, the proportion of diagnostic fees and Western drug costs decreased. The average hospitalization cost for surgical patients showed minimal change, while the non-surgical group experienced a significant reduction in average hospitalization costs. The DIP policy has demonstrated preliminary success in reducing the financial burden on patients, though further improvements in stability are needed.