Evidence-Based Medicine
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2024; 12(21): 4673-4679
Published online Jul 26, 2024. doi: 10.12998/wjcc.v12.i21.4673
Surgical treatment of liver cancer and pancreatic cancer under the China Healthcare Security Diagnosis Related Groups payment system
Yun-He Hu, Fan Yu, Yu-Zhuo Zhou, Ai-Dong Li
Yun-He Hu, Fan Yu, Yu-Zhuo Zhou, 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, Yu F, Zhou YZ and Li AD contributed equally to this work; Hu YH and Li AD were the guarantors of the integrity of the entire study; Hu YH performed the study concept and design; Hu YH, Yu F, Zhou YZ prepared 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.
Conflict-of-interest statement: Dr. Li has nothing to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: April 30, 2024
Revised: June 6, 2024
Accepted: June 7, 2024
Published online: July 26, 2024
Processing time: 62 Days and 10.5 Hours
Abstract
BACKGROUND

Data from the World Health Organization’s International Agency for Research on Cancer reported that China had the highest prevalence of cancer and cancer deaths in 2022. Liver and pancreatic cancers accounted for the highest number of new cases. Real-world data (RWD) is now widely preferred to traditional clinical trials in various fields of medicine and healthcare, as the traditional research approach often involves highly selected populations and interventions and controls that are strictly regulated. Additionally, research results from the RWD match global reality better than those from traditional clinical trials.

AIM

To analyze the cost disparity between surgical treatments for liver and pancreatic cancer under various factors.

METHODS

This study analyzed RWD 1137 cases within the HB1 group (patients who underwent pancreatectomy, hepatectomy, and/or shunt surgery) in 2023. It distinguished different expenditure categories, including medical, nursing, technical, management, drug, and consumable costs. Additionally, it assessed the contribution of each expenditure category to total hospital costs and performed cross-group comparisons using the non-parametric Kruskal–Wallis test. This study used the Steel–Dwass test for post-hoc multiple comparisons and the Spearman correlation coefficient to examine the relationships between variables.

RESULTS

The study found that in HB11 and HB13, the total hospitalization costs were significantly higher for pancreaticoduodenectomy than for pancreatectomy and hepatectomy. Although no significant difference was observed in the length of hospital stay between patients who underwent pancreaticoduodenectomy and pancreatectomy, both were significantly longer than those who underwent liver resection. In HB15, no significant difference was observed in the total cost of hospitalization between pancreaticoduodenectomy and pancreatectomy; however, both were significantly higher than those in hepatectomy. Additionally, the length of hospital stay was significantly longer for patients who underwent pancreaticoduodenectomy than for those who underwent pancreatectomy or liver resection.

CONCLUSION

China Healthcare Security Diagnosis Related Groups payment system positively impacts liver and pancreatic cancer surgeries by improving medical quality and controlling costs. Further research could refine this grouping system and ensure continuous effectiveness and sustainability.

Keywords: China health care security diagnosis-related groups; Real-world study; Liver cancer surgical treatment; Pancreatic cancer surgical treatment; Hospitalization costs; Cost structure; Average length of stay

Core Tip: To analyze cost differences and their influencing factors in surgical treatments for liver and pancreatic cancer within the China Healthcare Security Diagnosis Related Groups (CHS-DRG) payment system, this study aims to examine the appropriateness of the current diagnosis-related groups groupings and provide recommendations for improvement. The CHS-DRG payment system has shown a positive impact on the surgical treatment of liver and pancreatic cancer by enhancing medical quality and managing costs. However, additional research is necessary to refine the grouping system and ensure its continued effectiveness and sustainability.