The effects of diagnosis-related groups payment on hospital healthcare in China: a systematic review
The effects of diagnosis-related groups payment on hospital healthcare in China: a systematic review (BiomedCentral).
There has been a growing interest in using diagnosis-related groups (DRGs) payment to reimburse inpatient care worldwide. But its effects on healthcare and health outcomes are controversial, and the evidence from low- and middle-income countries (LMICs) is especially scarce. The objective of this study is to evaluate the effects of DRGs payment on healthcare and health outcomes in China.
Method
A systematic review was conducted. We searched literature databases of PubMed,
Cochrane Library, EMBASE, Web of Science, Chinese National Knowledge
Infrastructure and SinoMed for empirical studies examining the effects of DRGs
payment on healthcare in mainland China. [...]
Results
Twenty-three publications representing thirteen DRGs payment studies were
included, including six controlled before after studies, two interrupted time
series studies and five uncontrolled before-after studies. [...]
Conclusion
DRGs payment may mildly improve the efficiency but impair the equity and
quality of healthcare, especially for patients exempted from this payment
scheme, and may cause up-coding of medical records. However, DRGs payment may
or may not contain the total expenditure or OOP, depending on the components
design of the payment. Policymakers should very carefully consider each
component of DRGs payment design against policy goals. Well-designed randomised
trials or comparative studies are warranted to consolidate the evidence of the
effects of DRGs payment on healthcare and health outcomes in LMICs to inform
policymaking.
Quelle: BiomedCentral, 12.02.2020
