Comparison of hospitalization expenses for identical diseases between traditional Chinese medicine and Western medicine hospitals based on interrupted time-series analysis_Chinese Journal of Evidence-Based Medicine

Authors：

CHU Tianshu ¹ , WANG Lili ¹ , XU Yifan ¹ , ZHANG Huiwen ¹ , WANG Junwei ² ,  JING Limei ¹

1. Shanghai University of Traditional Chinese Medicine, School of Public Health, Shanghai 201203, P. R. China;
2. Pudong Institute for Health Development, Shanghai 200129, P. R. China;

Corresponding?author：

JING Limei, Email: limei_jing@163.com

Keywords：

Interrupted time-series analysis; Hospitalization expenses; Woman-related malignant tumor; Payment system reform; COVID-19 pandemic

DOI：

10.7507/1672-2531.202211120

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective In light of the comprehensively implemented reform of medical insurance payments, this study analyzed the impact of the payment intervention and COVID-19 pandemic on hospitalization expenses for identical diseases between traditional Chinese medicine (TCM) and Western medicine hospitals, to provide evidence to promote high-quality coordinated development of hospitals and insurance while reducing patient load. Methods From January 2014 to December 2020, we gathered data including 9 900 individual medical records of woman-related malignant tumors (WMT) from all 23 public hospitals in a district of Shanghai. We developed an interrupted time-series analysis model based on the above two interventions, to compare the inpatient average per-time expenses between different hospitals and different groups. Results The average per-time expenses of WMT in Western hospitals changed from rising to declining after the policy intervention, and increased again during the pandemic. In TCM hospitals, the expenses continued to increase and fluctuated after the pandemic. Conclusion The policy intervention has achieved a good effect on controlling the cost of Western hospitals, rather than the significant increase in TCM hospitals. Meanwhile, the COVID-19 pandemic has had a significant impact on hospitalization expenses. It’s urgent to develop a payment model that fits the development and characteristics of TCM, to control the unreasonable growth of expenses. Moreover, the financial compensation methods and supervision mechanism of public hospitals should be improved to effectively resist the threat of public health emergencies for the development of hospitals and the legitimate rights of patients.

Citation： CHU Tianshu, WANG Lili, XU Yifan, ZHANG Huiwen, WANG Junwei, JING Limei. Comparison of hospitalization expenses for identical diseases between traditional Chinese medicine and Western medicine hospitals based on interrupted time-series analysis. Chinese Journal of Evidence-Based Medicine, 2023, 23(3): 279-285. doi: 10.7507/1672-2531.202211120 Copy

1.	Ma Y, Wang W. The impact of diagnosis related group payment on the performance of public hospitals. Am J Transl Res, 2021, 13(6): 6796-801.
2.	陳焱秋, 張冬兒, 唐文熙. 基于文獻計量分析的我國單病種付費模式及效果研究. 中國醫院管理, 2020, 40(2): 5-7.
3.	李彧, 郭文東, 李建邦, 等. 按病種付費模式對醫院醫保管理的影響. 現代醫院, 2020, 20(12): 1824-1826.
4.	張森琳, 楊燕綏. DRG支付方式改革對醫院管理的影響分析. 中國醫藥科學, 2020, 10(17): 189-192.
5.	劉東國, 李堯, 郭玉紅, 等. DRG在中醫醫院醫療管理中的應用分析. 中國醫院管理, 2020, 40(7): 44-47.
6.	石連忠, 梅彥, 余震, 等. 杭州市DRG中醫支付政策的實踐探索. 衛生經濟研究, 2021, 38(12): 16-19.
7.	曹毛毛, 陳萬青. GLOBOCAN2020全球癌癥統計數據解讀. 中國醫學前沿雜志(電子版), 2021, 13(3): 63-69.
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10.	田欣, 包小源, 周子君. 基于31792例住院患者病案首頁數據的乳腺癌病例分組打包付費研究. 中華醫院管理雜志, 2020, 36(3): 193-197.
11.	沈松. 乳腺癌手術臨床路徑及其應用價值研究. 上海: 復旦大學, 2008.
12.	張晶. BJ-DRGs方法對呂梁市某三甲醫院女性生殖系統疾病及功能障礙住院病例的適用性研究. 太原: 山西醫科大學, 2019.
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14.	胡廣宇, 劉立煌, 吳世超, 等. 基于間斷時間序列分析的DRG-PPS改革效果研究. 中國衛生政策研究, 2019, 12(10): 23-28.
15.	Linden A, Adams JL. Applying a propensity score-based weighting model to interrupted time series data: improving causal inference in programme evaluation. J Eval Clin Pract, 2011, 17(6): 1231-1238.
16.	Abadie A, Diamond A, Hainmueller J. Synthetic control methods for comparative case studies: estimating the effect of California’s tobacco control program. J Am Stat Assoc, 2010, 105(490): 493-505.
17.	張予, 林宗秀, 劉開琴, 等. 1999-2018年貴州省黔南州女性生殖系統主要惡性腫瘤發病趨勢分析. 現代預防醫學, 2020, 47(10): 1807-1810.
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19.	任琳, 高楠, 張曉梅, 等. 應用中斷時間序列分析日間手術對平均住院日的影響. 中國衛生統計, 2021, 38(4): 536-538.
20.	楊曉雪. 公立醫院補償機制改革對東營市二三級公立綜合醫院經濟運行的影響研究. 濟南: 山東大學, 2020.
21.	徐學萍. 基于疾病診斷相關分組(DRG)原則的住院費用研究. 濟南: 山東大學, 2020.
22.	楊勇, 滿曉瑋, 尹學珺, 等. 醫療保險支付方式改革下中醫按病種付費的可行性與問題研究. 中醫藥管理雜志, 2018, 26(24): 1-4,40.
23.	董乾. DRG實施對三級醫院住院費用的影響研究. 北京: 北京中醫藥大學, 2021.
24.	孫璨, 馮占春. 中醫院按病種付費支付方式改革現狀分析. 中國醫院, 2022, 26(6): 16-18.
25.	王俊, 孫樹學, 張福康, 等. 新型冠狀病毒肺炎疫情對公立醫院服務供給的影響—基于北京市F醫院的實證研究. 中國衛生政策研究, 2021, 14(2): 28-35.
26.	路鳳, 郭默寧, 董兆敏, 等. COVID-19疫情對北京市公立醫院住院服務量的影響及其恢復情況分析. 中國衛生政策研究, 2020, 13(10): 48-53.

1. Ma Y, Wang W. The impact of diagnosis related group payment on the performance of public hospitals. Am J Transl Res, 2021, 13(6): 6796-801.
2. 陳焱秋, 張冬兒, 唐文熙. 基于文獻計量分析的我國單病種付費模式及效果研究. 中國醫院管理, 2020, 40(2): 5-7.
3. 李彧, 郭文東, 李建邦, 等. 按病種付費模式對醫院醫保管理的影響. 現代醫院, 2020, 20(12): 1824-1826.
4. 張森琳, 楊燕綏. DRG支付方式改革對醫院管理的影響分析. 中國醫藥科學, 2020, 10(17): 189-192.
5. 劉東國, 李堯, 郭玉紅, 等. DRG在中醫醫院醫療管理中的應用分析. 中國醫院管理, 2020, 40(7): 44-47.
6. 石連忠, 梅彥, 余震, 等. 杭州市DRG中醫支付政策的實踐探索. 衛生經濟研究, 2021, 38(12): 16-19.
7. 曹毛毛, 陳萬青. GLOBOCAN2020全球癌癥統計數據解讀. 中國醫學前沿雜志(電子版), 2021, 13(3): 63-69.
8. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
9. 嚴月康, 劉杰, 楊榮榮, 等. 2015—2018年贛州市女性生殖系統惡性腫瘤的疾病負擔分析. 現代預防醫學, 2022, 49(1): 9-11,16.
10. 田欣, 包小源, 周子君. 基于31792例住院患者病案首頁數據的乳腺癌病例分組打包付費研究. 中華醫院管理雜志, 2020, 36(3): 193-197.
11. 沈松. 乳腺癌手術臨床路徑及其應用價值研究. 上海: 復旦大學, 2008.
12. 張晶. BJ-DRGs方法對呂梁市某三甲醫院女性生殖系統疾病及功能障礙住院病例的適用性研究. 太原: 山西醫科大學, 2019.
13. 許敏旋. 城市公立醫院補償機制改革對醫院經濟運行的影響. 濟南: 山東大學, 2018.
14. 胡廣宇, 劉立煌, 吳世超, 等. 基于間斷時間序列分析的DRG-PPS改革效果研究. 中國衛生政策研究, 2019, 12(10): 23-28.
15. Linden A, Adams JL. Applying a propensity score-based weighting model to interrupted time series data: improving causal inference in programme evaluation. J Eval Clin Pract, 2011, 17(6): 1231-1238.
16. Abadie A, Diamond A, Hainmueller J. Synthetic control methods for comparative case studies: estimating the effect of California’s tobacco control program. J Am Stat Assoc, 2010, 105(490): 493-505.
17. 張予, 林宗秀, 劉開琴, 等. 1999-2018年貴州省黔南州女性生殖系統主要惡性腫瘤發病趨勢分析. 現代預防醫學, 2020, 47(10): 1807-1810.
18. 《國際疾病分類ICD-10應用指導手冊》. 上海: 中華醫院管理學會第十次全國病案管理學術會議論文集, 2001.
19. 任琳, 高楠, 張曉梅, 等. 應用中斷時間序列分析日間手術對平均住院日的影響. 中國衛生統計, 2021, 38(4): 536-538.
20. 楊曉雪. 公立醫院補償機制改革對東營市二三級公立綜合醫院經濟運行的影響研究. 濟南: 山東大學, 2020.
21. 徐學萍. 基于疾病診斷相關分組(DRG)原則的住院費用研究. 濟南: 山東大學, 2020.
22. 楊勇, 滿曉瑋, 尹學珺, 等. 醫療保險支付方式改革下中醫按病種付費的可行性與問題研究. 中醫藥管理雜志, 2018, 26(24): 1-4,40.
23. 董乾. DRG實施對三級醫院住院費用的影響研究. 北京: 北京中醫藥大學, 2021.
24. 孫璨, 馮占春. 中醫院按病種付費支付方式改革現狀分析. 中國醫院, 2022, 26(6): 16-18.
25. 王俊, 孫樹學, 張福康, 等. 新型冠狀病毒肺炎疫情對公立醫院服務供給的影響—基于北京市F醫院的實證研究. 中國衛生政策研究, 2021, 14(2): 28-35.
26. 路鳳, 郭默寧, 董兆敏, 等. COVID-19疫情對北京市公立醫院住院服務量的影響及其恢復情況分析. 中國衛生政策研究, 2020, 13(10): 48-53.

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Chinese Journal of Evidence-Based Medicine

Comparison of hospitalization expenses for identical diseases between traditional Chinese medicine and Western medicine hospitals based on interrupted time-series analysis

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