TY - JOUR
T1 - Beijing's diagnosis-related group payment reform pilot
T2 - Impact on quality of acute myocardial infarction care
AU - Jian, Weiyan
AU - Lu, Ming
AU - Liu, Guofeng
AU - Chan, Kit Yee
AU - Poon, Adrienne N
N1 - Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.
PY - 2019/10/5
Y1 - 2019/10/5
N2 - In 2012, China's first diagnosis-related group (DRG) payment system was piloted in Beijing. This study explored whether this payment pilot improved quality and reduced costs of acute myocardial infarction (AMI) care in hospitals implementing DRG payment as compared to control hospitals. A difference-in-difference study design was used with regression and considered several quality indicators including aspirin at arrival, aspirin at discharge, β-blocker at arrival, β-blocker at discharge, statin at discharge, in-hospital mortality, and 30-day readmission rates. DRG payment mechanisms without specific mechanisms to promote care quality did not improve quality of AMI care. Future studies should study the impact of cost control mechanisms together with quality improvement efforts to assess how quality of care may be improved within the Chinese healthcare system. These lessons would be helpful to share with lower-middle-income countries undergoing rapid development that are transitioning to a significantly higher burden of non-communicable diseases.
AB - In 2012, China's first diagnosis-related group (DRG) payment system was piloted in Beijing. This study explored whether this payment pilot improved quality and reduced costs of acute myocardial infarction (AMI) care in hospitals implementing DRG payment as compared to control hospitals. A difference-in-difference study design was used with regression and considered several quality indicators including aspirin at arrival, aspirin at discharge, β-blocker at arrival, β-blocker at discharge, statin at discharge, in-hospital mortality, and 30-day readmission rates. DRG payment mechanisms without specific mechanisms to promote care quality did not improve quality of AMI care. Future studies should study the impact of cost control mechanisms together with quality improvement efforts to assess how quality of care may be improved within the Chinese healthcare system. These lessons would be helpful to share with lower-middle-income countries undergoing rapid development that are transitioning to a significantly higher burden of non-communicable diseases.
U2 - 10.1016/j.socscimed.2019.112590
DO - 10.1016/j.socscimed.2019.112590
M3 - Article
C2 - 31683116
SN - 0277-9536
VL - 243
SP - 112590
JO - Social Science & Medicine
JF - Social Science & Medicine
ER -