Volume 10,Issue 4
Trends in Hospitalization Costs for COPD Patients: A Policy Coordination Perspective
Objective: To investigate the impact of integrating clinical pathways with Diagnosis-Related Groups (DRG) from a policy synergy perspective on hospitalization costs, healthcare efficiency, and cost structure for patients with chronic obstructive pulmonary disease (COPD), and to explore pathway optimization strategies adapting to the DRG 2.0 grouping policy, thereby enhancing the efficiency of medical insurance fund utilization. Methods: Using a tertiary hospital in Jinhua City as a case study, 7,015 medical insurance patients with a primary diagnosis of COPD admitted between 2020 and 2024 were selected. Interrupted Time Series Analysis (ITSA) and Structural Variation Analysis were employed to assess trends in hospitalization costs and other indicators. Results: Total hospitalization costs exhibited a significant short-term decrease (p = 0.003). Laboratory and examination costs decreased both in the short and long term (all p < 0.05). However, antimicrobial medication costs demonstrated a long-term upward trend (p = 0.007). Length of stay (LOS) decreased by 0.29 days in the short term. Western medications (contribution rate: 29.19%) and comprehensive medical services (contribution rate: 24.98%) were identified as key factors driving structural changes. Conclusion: Effective synergy between DRG and clinical pathways can reduce total hospitalization costs and shorten LOS for COPD patients, while optimizing cost structures. However, close attention must be paid to the unreasonable increase in antimicrobial medication costs. “Value-based healthcare” may represent a future trend for achieving a win-win scenario for cost control and healthcare quality.
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