To analyze the impact of disease diagnosis-related groups(DRG) point payment on average hospitalization costs and days of surgery patients with malignant tumors, so as to provide references for optimizing the policies of medical insurance payment.

The medical record homepage data of surgery patients with lung, colorectal, and thyroid malignant tumor in four tertiary comprehensive hospitals in Ningbo from July 2019 to June 2022 were selected from the comprehensive supervision platform of medical institutions, and the informations on patient hospitalization costs and length of stay were extracted. The structural variation and interruption time series analysis methods were used to analyze the changes in the average hospitalization costs, cost structure, and average hospitalization days of three types of malignant tumor surgery patients after the implementation of DRG point payment(January 2021).

A total of 39 708 patients were included in the medical records, including 19 635, 6 073, and 14 000 patients surgery with malignant tumors of the lungs, rectum, and thyroid, respectively. The average hospitalization cost for patients patients malignant tumor increased from 29 662 yuan before the implementation of DRG point payment to 3 097 yuan after implementation(P<0.05), and the average length of hospital stay decreased from 10.83 days to 9.42 days(P<0.05). The highest proportion of hospitalization costs for patients costs malignant tumor surgery was consumables expenses(35.12%), followed by treatment expenses (23.52%). After the implementation of DRG point payment, the proportion of drug expenses decreased by 2.98%, while the proportion of comprehensive medical service expenses, treatment expenses, inspection expenses, and consumables expenses increased by 0.90%, 0.23%, 0.93%, and 0.92%, respectively; Among them, the structural change contribution rate of drug expenses was the highest(50.13%), followed by inspection expenses(15.59%) and consumables expenses(15.34%). Through interruption time series analysis, it was found that after the implementation of DRG point payment method, the average hospitalization cost per visit of lung cancer patients showed a slow growth trend(P<0.05), but the growth trend of average hospitalization cost per visit of the other two types of patients slowed down(P>0.05); The average length of hospital stay for surgery patients of three types of malignant tumors showed a relatively flat downward trend(P>0.05).

After the implementation of the DRG point payment method, the average hospitalization costs for malignant tumor surgery in four hospitals in Ningbo had increased overall, but the upward trend had slowed down, and the cost structure had been optimized to a certain extent; At the same time, the average length of hospital stay for patients had been shortened, and the trend of change was relatively flat. It was recommended to strengthen the supervision of inspection items and medical consumables while implementing the DRG point based payment policy.

Medical insurance payment policy; Diagnosis-related groups; Point payment; Malignant tumors; Structural variation analysis; Interrupted time series analysis