Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2024; 12(20): 4174-4179
Published online Jul 16, 2024. doi: 10.12998/wjcc.v12.i20.4174
Cost analysis of radical resection of malignant breast tumors under the China Healthcare Security Diagnosis Related Groups payment system
Yun-He Hu, Ai-Dong Li
Yun-He Hu, Ai-Dong Li, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Author contributions: Hu YH and Li AD contributed equally to this work; Hu Y and Li AD were the guarantors of the integrity of the entire study; Hu YH worked on the study concept and design; Hu YH prepared the manuscript and wrote the manuscript; all authors have access to the data and played a role in writing this manuscript.
Supported by Research Center for Capital Health Management and Policy, No. 2024JD09.
Institutional review board statement: This study does not involve medical ethics.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous data that were obtained from Beijing Area Impatient Medical Service Performance platform.
Conflict-of-interest statement: The authors report that they have no relevant conflicts of interest to disclose.
Data sharing statement: The dataset is available from the corresponding author upon request at aidong_li1208@sina.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ai-Dong Li, Associate Research Scientist, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan South Lane, Chaoyang District, Beijing 100021, China. aidong_li1208@sina.com
Received: March 24, 2024
Revised: May 21, 2024
Accepted: May 23, 2024
Published online: July 16, 2024
Processing time: 98 Days and 19.6 Hours
Abstract
BACKGROUND

Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health. Therefore, this study examined patients who underwent breast cancer surgery, analyzed hospitalization costs and structure, and explored the impact of China Healthcare Security Diagnosis Related Groups (CHS-DRG) management on patient costs. It aimed to provide medical institutions with ways to reduce costs, optimize cost structures, reduce patient burden, and improve service efficiency.

AIM

To study the CHS-DRG payment system’s impact on breast cancer surgery costs.

METHODS

Using the CHS-DRG (version 1.1) grouping criteria, 4073 patients, who underwent the radical resection of breast malignant tumors from January to December 2023, were included in the JA29 group; 1028 patients were part of the CHS-DRG payment system, unlike the rest. Through an independent sample t-test, the length of hospital stay as well as total hospitalization, medicine and consumables, medical, nursing, medical technology, and management expenses were compared. Pearson’s correlation coefficient was used to test the cost correlation.

RESULTS

In terms of hospitalization expenses, patients in the CHS-DRG payment group had lower medical, nursing, and management expenses than those in the diagnosis-related group (DRG) non-payment group. For patients in the DRG payment group, the factors affecting the total hospitalization cost, in descending order of relevance, were medicine and consumable costs, consumable costs, medicine costs, medical costs, medical technology costs, management costs, nursing costs, and length of hospital stay. For patients in the DRG non-payment group, the factors affecting the total hospitalization expenses in descending order of relevance were medicines and consumable expenses, consumable expenses, medical technology expenses, the cost of medicines, medical expenses, nursing expenses, length of hospital stay, and management expenses.

CONCLUSION

The CHS-DRG system can help control and reduce unnecessary medical expenses by controlling medicine costs, medical consumable costs, and the length of hospital stay while ensuring medical safety.

Keywords: China Healthcare Security Diagnosis Related Groups; Real-world study; Radical resection of malignant breast tumors; Hospitalization costs; Cost structure; Average length of stay

Core Tip: Patients undergoing the radical resection of breast malignant tumors and included under the China Healthcare Security Diagnosis Related Groups payment system have to bear lower medical, nursing, and management costs after hospitalization than those who are not managed by the system. Medicine and consumables, consumables, medicines, medical, medical technology, administrative, and nursing expenses and length of stay have a significant impact on hospitalization expenses.