[1]方鑫磊,黄明智.DRG支付改革对结直肠癌手术患者住院费用的影响研究 ——基于PSM-DID实证分析[J].卫生经济研究,2026,43(07):69-73,78.
　FANG Xinlei,HUANG Mingzhi.Impact of DRG Payment Reform on Hospitalization Expenses for Colorectal Cancer Surgery Patients ——Empirical Analysis Based on PSM-DID[J].Journal Press of Health Economics Research,2026,43(07):69-73,78.
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DRG支付改革对结直肠癌手术患者住院费用的影响研究
——基于PSM-DID实证分析

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
43
期数:
2026年07期
页码:
69-73,78
栏目:
疾病负担
出版日期:
2026-07-03

文章信息/Info

Title:
Impact of DRG Payment Reform on Hospitalization Expenses for Colorectal Cancer Surgery Patients
——Empirical Analysis Based on PSM-DID
作者:
方鑫磊1; 黄明智1
1.蚌埠医科大学第一附属医院，安徽 蚌埠 233000
Author(s):
FANG Xinlei;  HUANG Mingzhi
The First Affiliated Hospital of Bengbu Medical University, Bengbu Anhui 233000, China
关键词:
DRG支付改革; 结直肠癌手术; 住院费用; 双重差分分析
Keywords:
DRG payment reform;  colorectal cancer surgery;  hospitalization expenses;  difference-in-differences analysis
分类号:
R19
文献标志码:
A
摘要:
目的：分析DRG支付改革对结直肠癌手术患者住院费用结构及医疗资源分配的影响，为优化医保支付政策提供实证依据。方法：基于2019—2024年某医院4 112例结直肠癌手术患者病案首页数据，按支付方式分为本地医保组（处理组）与异地医保/自费组（对照组），采用倾向得分匹配-双重差分法，分析DRG支付改革的净效应，通过三重差分模型分析改革对高龄患者的异质性影响。结果：DRG支付改革后，患者住院总费用下降4.7%，其中，综合服务费下降75.5%，但耗材费占比由31.7%上升至38.9%，患者住院时间缩短8.0%；DRG支付改革没有对高龄患者产生歧视性效应，但普遍出现综合服务压缩及耗材依赖增强现象。结论：DRG支付改革在实现控费目标的同时，导致医疗服务供给的结构性扭曲，对医疗质量与系统公平构成潜在影响；对此，应通过DRG-质量捆绑支付机制、耗材分类管控及高龄患者风险校正机制，实现“控费、提质、公平”的政策协同。
Abstract:
Objective To analyze the impact of DRG payment reform on the hospitalization cost structure and medical resource allocation for patients undergoing colorectal cancer surgery, providing empirical evidence for optimizing medical insurance payment policies. Methods Based on the front-page medical record data of 4 112 patients who underwent colorectal cancer surgery in a hospital from 2019 to 2024, patients were divided into a local medical insurance group (treatment group) and a non-local medical insurance/self-pay group(control group) according to payment method. The propensity score matching-difference-in-differences(PSM-DID) method was used to analyze the net effect of the DRG payment reform, and a triple difference(DDD) model was used to analyze the heterogeneous impact of the reform on elderly patients. Results After the implementation of DRG payment reform, the total hospitalization cost of patients decreased by 4.7%, in which comprehensive service fees decreased by 75.5%, while the proportion of consumable costs increased from 31.7% to 38.9%. The length of hospital stay was shortened by 8.0%. Further analysis revealed that the DRG payment reform did not have a discriminatory effect on elderly patients, but a general compression of comprehensive services and increased reliance on consumables were observed. Conclusion The DRG payment reform achieved cost control goals but led to structural distortions in medical service supply, posing potential impacts on medical quality and systemic equity. It is recommended to adopt a DRG-quality bundled payment mechanism, stratified management of consumables, and a risk-adjusted payment mechanism for elderly patients to achieve policy coordination of "cost control, quality improvement, and equity".

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更新日期/Last Update: 2026-07-03