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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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.	陈焱秋, 张冬儿, 唐文熙. 基于文献计量分析的我国单病种付费模式及效果研究. 中国医院管理, 2020, 40(2): 5-7.
3.	李彧, 郭文东, 李建邦, 等. 按病种付费模式对医院医保管理的影响. 现代医院, 2020, 20(12): 1824-1826.
4.	张森琳, 杨燕绥. DRG支付方式改革对医院管理的影响分析. 中国医药科学, 2020, 10(17): 189-192.
5.	刘东国, 李尧, 郭玉红, 等. DRG在中医医院医疗管理中的应用分析. 中国医院管理, 2020, 40(7): 44-47.
6.	石连忠, 梅彦, 余震, 等. 杭州市DRG中医支付政策的实践探索. 卫生经济研究, 2021, 38(12): 16-19.
7.	曹毛毛, 陈万青. GLOBOCAN2020全球癌症统计数据解读. 中国医学前沿杂志(电子版), 2021, 13(3): 63-69.
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10.	田欣, 包小源, 周子君. 基于31792例住院患者病案首页数据的乳腺癌病例分组打包付费研究. 中华医院管理杂志, 2020, 36(3): 193-197.
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12.	张晶. BJ-DRGs方法对吕梁市某三甲医院女性生殖系统疾病及功能障碍住院病例的适用性研究. 太原: 山西医科大学, 2019.
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14.	胡广宇, 刘立煌, 吴世超, 等. 基于间断时间序列分析的DRG-PPS改革效果研究. 中国卫生政策研究, 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.
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19.	任琳, 高楠, 张晓梅, 等. 应用中断时间序列分析日间手术对平均住院日的影响. 中国卫生统计, 2021, 38(4): 536-538.
20.	杨晓雪. 公立医院补偿机制改革对东营市二三级公立综合医院经济运行的影响研究. 济南: 山东大学, 2020.
21.	徐学萍. 基于疾病诊断相关分组(DRG)原则的住院费用研究. 济南: 山东大学, 2020.
22.	杨勇, 满晓玮, 尹学珺, 等. 医疗保险支付方式改革下中医按病种付费的可行性与问题研究. 中医药管理杂志, 2018, 26(24): 1-4,40.
23.	董乾. DRG实施对三级医院住院费用的影响研究. 北京: 北京中医药大学, 2021.
24.	孙璨, 冯占春. 中医院按病种付费支付方式改革现状分析. 中国医院, 2022, 26(6): 16-18.
25.	王俊, 孙树学, 张福康, 等. 新型冠状病毒肺炎疫情对公立医院服务供给的影响—基于北京市F医院的实证研究. 中国卫生政策研究, 2021, 14(2): 28-35.
26.	路凤, 郭默宁, 董兆敏, 等. COVID-19疫情对北京市公立医院住院服务量的影响及其恢复情况分析. 中国卫生政策研究, 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. 陈焱秋, 张冬儿, 唐文熙. 基于文献计量分析的我国单病种付费模式及效果研究. 中国医院管理, 2020, 40(2): 5-7.
3. 李彧, 郭文东, 李建邦, 等. 按病种付费模式对医院医保管理的影响. 现代医院, 2020, 20(12): 1824-1826.
4. 张森琳, 杨燕绥. DRG支付方式改革对医院管理的影响分析. 中国医药科学, 2020, 10(17): 189-192.
5. 刘东国, 李尧, 郭玉红, 等. DRG在中医医院医疗管理中的应用分析. 中国医院管理, 2020, 40(7): 44-47.
6. 石连忠, 梅彦, 余震, 等. 杭州市DRG中医支付政策的实践探索. 卫生经济研究, 2021, 38(12): 16-19.
7. 曹毛毛, 陈万青. GLOBOCAN2020全球癌症统计数据解读. 中国医学前沿杂志(电子版), 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. 严月康, 刘杰, 杨荣荣, 等. 2015—2018年赣州市女性生殖系统恶性肿瘤的疾病负担分析. 现代预防医学, 2022, 49(1): 9-11,16.
10. 田欣, 包小源, 周子君. 基于31792例住院患者病案首页数据的乳腺癌病例分组打包付费研究. 中华医院管理杂志, 2020, 36(3): 193-197.
11. 沈松. 乳腺癌手术临床路径及其应用价值研究. 上海: 复旦大学, 2008.
12. 张晶. BJ-DRGs方法对吕梁市某三甲医院女性生殖系统疾病及功能障碍住院病例的适用性研究. 太原: 山西医科大学, 2019.
13. 许敏旋. 城市公立医院补偿机制改革对医院经济运行的影响. 济南: 山东大学, 2018.
14. 胡广宇, 刘立煌, 吴世超, 等. 基于间断时间序列分析的DRG-PPS改革效果研究. 中国卫生政策研究, 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. 张予, 林宗秀, 刘开琴, 等. 1999-2018年贵州省黔南州女性生殖系统主要恶性肿瘤发病趋势分析. 现代预防医学, 2020, 47(10): 1807-1810.
18. 《国际疾病分类ICD-10应用指导手册》. 上海: 中华医院管理学会第十次全国病案管理学术会议论文集, 2001.
19. 任琳, 高楠, 张晓梅, 等. 应用中断时间序列分析日间手术对平均住院日的影响. 中国卫生统计, 2021, 38(4): 536-538.
20. 杨晓雪. 公立医院补偿机制改革对东营市二三级公立综合医院经济运行的影响研究. 济南: 山东大学, 2020.
21. 徐学萍. 基于疾病诊断相关分组(DRG)原则的住院费用研究. 济南: 山东大学, 2020.
22. 杨勇, 满晓玮, 尹学珺, 等. 医疗保险支付方式改革下中医按病种付费的可行性与问题研究. 中医药管理杂志, 2018, 26(24): 1-4,40.
23. 董乾. DRG实施对三级医院住院费用的影响研究. 北京: 北京中医药大学, 2021.
24. 孙璨, 冯占春. 中医院按病种付费支付方式改革现状分析. 中国医院, 2022, 26(6): 16-18.
25. 王俊, 孙树学, 张福康, 等. 新型冠状病毒肺炎疫情对公立医院服务供给的影响—基于北京市F医院的实证研究. 中国卫生政策研究, 2021, 14(2): 28-35.
26. 路凤, 郭默宁, 董兆敏, 等. COVID-19疫情对北京市公立医院住院服务量的影响及其恢复情况分析. 中国卫生政策研究, 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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