Effects of DRG/DIP payment reform on hospital pharmacy administration and pharmaceutical services in China: a multicenter cross-sectional study

Xuanxuan Wang¹Yun Tao²Suyu Gao¹Jiajia Feng²Huang Anqi¹Lin Likai^2*Hong Cheng^1*

• ¹Department of Pharmacy, Zhongnan Hospital, Wuhan University, Wuhan, China
• ²Institute of Hospital Management, Zhongnan Hospital, Wuhan University, Wuhan, Hebei Province, China

In China, a government-led policy introduced in 2019 and 2020 aims to reduce medical costs through a national medical care payment system based on Diagnostic-Related Groups (DRG) and Diagnosis-Intervention Packet (DIP). Hospital pharmacists play a crucial role in the implementation of this policy by enhancing the rational use of medicines and delivering pharmaceutical services. The purpose of this study is to assess the current state of hospital pharmacy administration and pharmaceutical services, while examining the effects of the DRG/DIP policy on these aspects.This multicenter cross-sectional study utilized a questionnaire survey to collect data. The questionnaire consisted of four main parts: participants' demographics, hospital and DRG/DIP payment information, hospital pharmacists' involvement in pharmacy administration and pharmaceutical services, and barriers and suggestions encountered in their work. The questionnaire was distributed to pharmacy department heads in hospitals across mainland China through convenience sampling, between September 2022 to December 2022. Multivariate logistic regression analysis was performed to identify factors associated with hospital pharmacy administration and pharmaceutical services.Results: A total of 655 pharmacists from 655 hospitals participated in the questionnaire survey. Pharmacists in DRG/DIP implemented hospitals were more involved in both pharmacy administration and pharmaceutical services compared to those in non-DRG/DIP implemented hospitals. The DRG/DIP reform was associated with improved hospital pharmacy administration (OR=1.87, 95%CI 1.26-2.77, p=0.002). Additionally, favorable outcomes in pharmaceutical services were associated with the DRG/DIP reform (OR=1.79, 95%CI 1.07-3.00, p=0.027) and enhanced pharmacy administration (OR=28.10, 95%CI 17.61-44.85, p<0.001).To effectively adapt the healthcare payment reform, it is suggested that the pharmacy department should adopt DRG/DIP as a strategic focus, continuously enhance pharmaceutical services capabilities and pharmacy administration systems, and achieve value optimization within the context of healthcare payment reform.