ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1567838
This article is part of the Research TopicInnovative Value-Based Medicine: Lessons from China's Healthcare EvolutionView all 6 articles
A Study of the Impact of DIP Payment Reform on Coronary Heart Disease Hospitalization Costs and Equity
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- Zhejiang Chinese Medical University, Hangzhou, China
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BACKGROUND: To control the growth of healthcare costs, the Chinese government introduced a diagnosis-intervention package (DIP)-based health insurance payment reform. This study evaluated the impact of the DIP policy on hospitalization costs, Length of Hospital Stay, and Out-of-Pocket Ratio for patients with coronary heart disease (CHD). METHODS: Hospitalization claims data from 2020-2023 in city S, central China, were selected and analyzed using interrupted time series (ITS), covering 264 hospitals with January 2022 as the intervention point. RESULTS: After the implementation of DIP, hospitalization costs decreased from 8.81 to 8.57 for employee health insurance(UEBMI) (p<0.001) and from 8.18 to 7.97 for resident health insurance(URRBMI) (p<0.001), with even greater decreases for primary and secondary hospitals. The number of days of hospitalization decreased, from 8.82 to 7.78 (p<0.001) for UEBMI and from 8.24 to 7.46 (p<0.001) for URRBMI, with the largest decrease in primary hospitals. As for out-of-pocket ratio,the URRBMI increased from 20.71% to 25.2% (p<0.001), and the UEBMI decreased from 28.67% to 23.57% (p<0.001).CONCLUSION: The DIP policy was effective in controlling hospitalization costs and days, especially in primary and secondary hospitals. However, the out-of-pocket ratio of URRBMI increased and UEBMI decreased, suggesting differential impact of the policy. It is recommended that policy makers pay attention to differences in health insurance types and hospital grades to optimize the fairness and effectiveness of the policy.
Keywords: DIP Payment Reform 1, Interrupted Time Series Analysis 2, Types of Health Insurance 3, Healthcare Cost Control 4, Healthcare Equity 5
Received: 29 Jan 2025; Accepted: 08 May 2025.
Copyright: © 2025 Tao, Shen, Chen, Li, Wu and Meng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xuehui Meng, Zhejiang Chinese Medical University, Hangzhou, China
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