目的: 评价DRG支付方式改革对中医院住院患者医疗费用和中医服务利用的影响。方法: 采用改革前后的对比研究设计,收集改革前、后12个月N市Z医院508例出院患者的病案首页资料,运用倾向性评分匹配法分析DRG改革对住院费用及中医服务利用的影响。结果: DRG改革后,三个病种的次均住院费用均有所下降,西药费与耗材费呈现下降趋势,中医类费用显著增加,中医设备使用率上升了23.38%。多因素回归表明,DRG改革后的次均住院费用降低了35%,DRG改革和住院天数是影响次均住院费用的重要因素。结论: DRG改革降低了住院费用,提高了中医服务利用。应规范中医治疗的临床路径,促进中医药服务合理使用。

Objective: The paper evaluates the effect of DRG payment method reform on the medical expenses of inpatients in traditional Chinese medicine (TCM) hospitals and the utilization of TCM services. Methods: A pre-post study design was conducted and the data of 508 discharged patients was collected from the first page of medical records in Z Hospital in N City 12 months before and after the reform. Propensity score matching method was used to analyzed the effect of DRG reform on hospitalization cost and TCM service utilization. Results: After the implementation of DRG reform, the total inpatient cost of the three diseases decreased, the cost of western medicine and consumables showed a downward trend, the cost of TCM increased significantly, and the utilization rate of TCM equipment increased by 23.38%. Multivariate regression showed that the average hospitalization cost decreased by 35% after the implementation of DRG reform, and the DRG reform policy and length of stay are important factors affecting the average hospitalization cost. Conclusion: DRG reform decreased inpatient costs and increased the use of TCM services. Clinical pathways for TCM treatment should be strengthened to promote rational use of TCM services.