Comparison of Diagnosis-Related Group Rehabilitation Reimbursement Payments With Those of a Novel Patient Classification-Based Payment System

Abstract

Objective

To compare the difference of reimbursement payments between diagnosis-related group (DRG) and a novel patient classification-based payment system, diagnosis-intervention packet (DIP), among rehabilitation inpatients in tertiary hospitals.

Design

Retrospective cohort study.

Setting

TTertiary hospitals in Shenzhen, China.

Participants

We assessed the records of 268,362 individuals who visited tertiary hospitals providing rehabilitation services.

Interventions

Not applicable.

Main Outcome Measures

The outcome variable was the patients’ rehabilitation hospitalization cost of in our study. A quantile regression analysis was conducted to estimate the effects of DIP payment on the rehabilitation hospitalization cost.

Results

The results showed that the predicted marginal hospitalization cost with DRG payment were 9%, 7%, 14%, and 10% higher than that with DIP payments in 2019, 2020, 2021, and 2022. The total difference in predicted marginal hospitalization cost between DRG and DIP was −1269 RMB (−193 USD). This difference in 2019, 2020, 2021, and 2022 was −1419 RMB (−228 USD), −1088 RMB (−158 USD), −1585 RMB (−246 USD), and −1034 RMB (−154 USD), respectively. All differences in predicted marginal hospitalization cost between DRG and DIP was significant (P<.001), after controlling for patients’ age, sex, public or private hospital, the type of disease, and the length of stay of hospitalization.

Conclusions

The findings of DIP payment reduced the rehabilitation hospitalization cost would be helpful in developing more effectively and efficiently tailored interventions for rehabilitation health care in China. Furthermore, the results of this study could provide advice on building more effective strategies and intervention options for other countries that struggle with controlling rehabilitation hospitalization costs.