In China, a new case-based payment method called the ‘Diagnosis-Intervention Packet’ (DIP) under the global budget was introduced for inpatient care. This study aims to explore the impact of DIP payment reform on hospital selection of patients undergoing total hip/knee arthroplasty (THA/TKA) or with arteriosclerotic heart disease (AHD) in a large city in China.
The findings highlight that patient severity increased in DIP hospitals and the treatment intensity for AHD patients significantly increased. The study suggests that DIP incentivizes providers to admit sicker patients and provide higher treatment intensity, rather than focusing on cost control. These findings underscore the need to balance cost containment with the unintended consequences of prospective payment systems and suggest that the DIP payment method could be a viable alternative payment system for other countries.