中国卫生事业管理2026，Vol.43Issue(5)：513-517,586,6.
DRG付费对住院前门诊医疗服务的影响研究
Impact of Diagnosis-Related Groups Based Payment on Outpatient Medical Service before Hospitalization Based on Evidence from Chronic Ischemic Heart Disease Patients
摘要
Abstract
Objective To examine the changes in outpatient medical service utilization and costs before hospitalization among pa-tients with chronic ischemic heart disease after the implementation of DRG payment system in City H,explore the impact of DRG pay-ment on outpatient medical services,and provide a reference for further improving medical insurance payment reform.Methods Using medical insurance claims data for hypertensive and diabetic patients with chronic ischemic heart disease in City H from 2019～2020,in-terrupted time series analysis was employed to evaluate changes in hospitalization service,outpatient medical service before hospitaliza-tion,and episode treatment costs before and after DRG implementation.Results Following DRG adoption,the average total hospitaliza-tion cost decreased immediately after the reform(β2=-0.080,P<0.05),while length of stay remained unchanged.Visits and costs of pre-admission outpatient service increased significantly,particularly in secondary and tertiary hospitals.Total treatment episode costs showed no significant variation.Conclusion After the implementation of DRG-based payment,inpatient services may shift to the pre-admission outpatient setting,highlighting the need for better outpatient management and payment reforms.关键词
DRG 付费/住院前门诊/慢性缺血性心脏病Key words
DRG-based payment/outpatient medical service before hospitalization/chronic ischemic heart disease分类
医药卫生引用本文复制引用
陈非非,张璐莹..DRG付费对住院前门诊医疗服务的影响研究[J].中国卫生事业管理,2026,43(5):513-517,586,6.基金项目
国家自然科学基金"战略性购买视角下医保门诊按人头付费机制研究"(72374049) （72374049）
