The effect of diagnosis-related group policy on treatment cost and treatment efficiency of inpatients with coronary heart disease in Xinjiang: an interrupted time series analysis

Background: The high incidence and economic burden of coronary heart disease (CHD) represent a major public health challenge in Xinjiang, a region in northwest China. We aimed to assess the effects of a diagnosis-related group (DRG) policy on treatment costs and treatment efficiency in Bortala Mongol Autonomous Prefecture, Kashgar, and Kizilsu Kirghiz Autonomous Prefecture of Xinjiang, China. Methods: We retrieved data on CHD inpatients from three prefectures in the Xinjiang medical insurance database. Then, we used interrupted time series analyses to evaluate the effect of the DRG policy on these inpatients. The analysis spanned the period from 1 January 2022 to 31 December 2024, with the policy intervention point for each prefecture defined by its respective DRG implementation date. We divided patients into pre-DRG and post-DRG groups based on the timing of the DRG policy's implementation. The outcome variables for treatment costs were total cost, drug cost, medical supplies cost, and out-of-pocket (OOP) payments; the outcome variable for treatment efficiency was length of stay (LOS). Results: = -26.898; 95% confidence interval (CI) = -45.303, -8.493; P = 0.004), and their LOS decreased significantly in both level (P = 0.001) and trend (P = 0.034). The total cost for CHD inpatients in Kashgar showed a significant downward trend, and drug cost decreased significantly in both level (P = 0.003) and trend (P < 0.001). However, we observed no statistically significant differences in the remaining indicators of the two regions, or for all changes for CHD inpatients in the Kizilsu Kirghiz Autonomous Prefecture (all P > 0.05). Conclusions: The DRG policy in Xinjiang has successfully controlled certain treatment costs and improved treatment efficiency for inpatients with CHD in the Bortala Mongol Autonomous Prefecture and in Kashgar. However, the implementation of DRG in the Kizilsu Kirghiz Autonomous Prefecture has not yet shown significant results and thus warrants monitoring and research.