Objective:Using real-world data, the paper examines the impact of diagnosis-related groups (DRG) payment reform on the utilization and costs of typical coronary interventional consumables (coronary stents and drug-coated balloons (DCB)), providing evidence for improving payment reform and consumables governance. Methods:Medical insurance settlement data of 179867 inpatient cases with coronary heart disease were collected from 27 DRG pilot hospitals (first and second batches) in City S from 2020 to 2022. Descriptive analysis and interrupted time series (ITS) analysis with a control group were applied to evaluate the effects of DRG reform on average quantity and cost per case, and utilization rate of the typical consumables. Further analyses of changes in average quantity and cost per case were conducted for different categories of stents. Results:After DRG reform, among all inpatients, average quantity and cost of stents per case decreased significantly, whereas the average quantity and cost of DCB per case increased significantly. ITS analysis indicated that, following DRG reform, stent quantity and utilization rate shifted from a post-volume-based procurement (VBP) high plateau to gradual decline, with sustained cost reduction. The rapid post-VBP growth of DCB quantity and utilization rate was curbed, achieving long-term stabilization. In the subgroup of patients undergoing stent implantation, selected products maintained high utilization at low cost, Non-selected products stabilized at persistently low utilization and cost levels following VBP implementation. Utilization and costs of out-of-scope stents exhibited a sustained convergent decline. Conclusion:DRG reform effectively constrained the expansion of stent utilization and costs, and complemented the VBP policy to form a coordinated pattern: VBP reduces prices, while DRG controls total volume and contains costs. It also reversed excessive DCB growth toward a pattern of stable volume with reduced costs. Overall, DRG reform promotes a shift from scale-driven to rational and value-oriented use of consumables, aligns with the clinical trend of “leave-nothing-behind”, and advances rational medical behavior and efficient resource allocation.
Key words
payment method reform /
diagnosis-related groups /
medical consumables /
interrupted time series analysis
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