DIP支付背景下恶性肿瘤患者住院费用结构变动度与灰色关联分析OACHSSCD

Employing a retrospective cohort study design,this research utilized the degree of structure variation and grey relational analysis,combined with CPI discount adjustment and the Jonckheere-Terpstra trend test,to evaluate changes in cost composition and resource allocation before and after the implementation of the diagnosis-intervention packet(DIP)at a tertiary hospital in Xiangyang with January 2023 as the cutoff point.Research indicates that in the second year after DIP implementation,the average total cost per case decreased by 24.38%compared to the pre-reform period,with a 60.81%reduction in consumable costs.Consumable cost control showed a one-year delayed response,with the reduction in 2024 exceeding that in 2023 by 27.7 percentage points.From 2020 to 2024,the proportion of drug expenses showed a downward trend,yet maintained the highest correlation(0.982).Meanwhile,the proportions of diagnostic and comprehensive medical service fees increased,respectively,with contribution rates rising.DIP reform drives hospitals to optimize resource allocation through a cost-accounting system,thereby significantly reducing the financial burden on malignant tumor patients.However,an"exceptional case review"mechanism should be established to address the lag in controlling high-cost drug expenses,while preventing clinical risks arising from excessive cost-cutting.