Objective: The paper evaluates the impact of linking DRG points with performance evaluation results on healthcare provider behavior. Methods: An interrupted time series analysis (ITSA) was conducted using monthly settlement data from January 2018 to December 2024 for all medical institutions in Panzhihua City participating in the DRG payment reform pilot, focusing on DT10 disease group (otitis media and upper respiratory infection, patients aged under 17). Results: The policy significantly reduced the proportion of medical consumables expenses among all hospitals for penalty-related indicators. Analysis by hospital level indicated that, the proportion of drug and medical consumables expenses declined in tertiary hospitals, while the downward trend in average length of stay was maintained. In secondary and primary hospitals, the proportion of medical consumables expenses declined significantly. Monitoring and constraint indicators were associated only with an increase in the proportion of medical service expenditures in primary hospitals. Conclusions: The policy linking DRG points with performance evaluation results contributed to managing medical consumables expenditures, whereas monitoring and constraint indicators demonstrated limited incentive effects and failed to induce substantial behavioral changes among medical institutions. DRG payment method reforms should prioritize incentive-compatible mechanisms, strengthen coordination with national volume-based procurement (VBP) and medical service pricing policies, and adopt differentiated performance assessmentand motivation mechanisms aligned with hospital functional roles. In the longer term, payment systems may consider a transition toward a value-based model that assessment and payment are linked to health outcomes.
Key words
DRG points /
performance evaluation /
healthcare provider behavior
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