To analyze the impact of diagnosis related group(DRG) payment reform on the medical services and hospitalization expenses of a certain specialized hospital, for references for strengthening the refined operation and management of specialized hospitals.

The study extracted the homepage data of inpatients in a certain specialized hospital before the implementation of DRG payment policy(January 2020 to June 2021) and after the implementation(January 2022 to June 2023). The medical service level of the hospital was comprehensively evaluated from three dimensions and eight indicators, including medical service capability, service efficiency, and quality and safety. Hospitalization expenses and their structure(comprehensive medical services, diagnosis, treatment, drugs, and consumables) was descriptive analyzed. The interrupted time series(ITS) method was used to analyze the trend of changes in per capita total hospitalization expenses and five types of costs before and after policy implementation.

A total of 155 960 hospitalized patients were included, with 75 788 cases(48.59%) before policy implementation and 80 172 cases(51.41%) after implementation. Compared with before policy implementation, the number of DRG groups, total weights, and CMI values after policy implementation increased by 0.61%, 8.34%, and 2.60%, respectively; The average length of hospital stay, cost expenditure index, and time expenditure index decreased by 11.24%, 1.02%, and 2.66%, respectively; The mortality rate of the low-risk group remained unchanged. The per capita total hospitalization expense increased from 14 205.16 yuan before policy implementation to 14586.12 yuan after implementation(P<0.05). In terms of cost composition, the proportion of treatment and drug expenses after policy implementation increased by 2.17% and 0.29% compared to before policy implementation, while the proportion of comprehensive medical service expenses, diagnosis expenses, and consumables expenses decreased by 0.47%, 1.77%, and 1.43%, respectively; In terms of cost trends, the per capita total hospitalization expenses and drug expenses after policy implementation showed an increasing trend(P<0.05), while comprehensive medical services, diagnosis, treatment, and consumables showed a decreasing trend(P<0.05).

The implementation of DRG payment policy was conducive to improving the level of medical services in specialized hospitals, promoting the rationalization of hospitalization expense structure, and affecting the trend of hospitalization expense changes. Among them, drug expense showed a slow growth trend, which required special attention.

Diagnosis related group; Payment policy; Medical services; Hospitalization expenses; Specialized hospitals; Interrupt time series