目的: 分析DRG付费改革对本地与省内异地医保患者住院费用的影响,进一步完善DRG付费政策。方法: 利用倾向性评分匹配性别、身份类型等指标,评估DRG付费改革对本地与省内异地就医医保患者住院费用的影响。结果: 实施DRG付费改革后,济南市本地医保患者比省内异地就医医保患者平均住院费用低2734.64元（P<0.05）,平均自费费用低2885.92元（P<0.05）,药品费用、服务项目费用、材料费用分别低1307.48元、1190.49元与239.01元（P<0.05）,药品费用占比、耗材费用占比分别低1.02%和0.18%,医疗服务项目费用占比高1.2%。结论: DRG付费改革有助于降低本地医保患者的平均住院费用,规范医院诊疗行为,建议DRG付费改革与异地就医结算政策协同推进。

Objective: The paper analyzes the influence of DRG payment reform on hospitalization costs of local and offsite medical insurance patients inside the province to further improve the DRG payment policy. Methods: The influence of DRG payment reform on hospitalization costs of local and offsite medical insurance patients inside the province was evaluated by matching gender, identity type and other indicators with propensity score. Results: After the implementation of DRG payment reform, the average hospitalization cost of medical insurance patients in Jinan was 2734.64 yuan lower than that of offsite medical insurance patients inside the province (P<0.05). The average out-of-pocket cost was 2885.92 yuan lower (P<0.05). Drug cost, service cost and material cost were 1307.48 yuan, 1190.49 yuan and 239.01 yuan lower (P<0.05), the proportion of drug cost and consumable cost were respectively1.02% and 0.18% lower, and the proportion of medical service cost was 1.2% higher. Conclusion: The DRG payment reform is helpful to reduce the average hospitalization cost of local medical insurance patients and regulate the diagnosis and treatment behavior in hospitals. It is suggested that the DRG payment reform and the billing policy for non-local medical treatment should be promoted in coordination.