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The Cost Control Effect of Hospitalization Expenses for Aplastic Anemia Patients in a Children\'s Hospital in Jiangsu Province under the DRG Payment Method Based on PSM

• 1、Suchoow University, School of Public Health, Suchoow 215000

Abstract：Objective To evaluate the cost control effect of the Diagnosis-Related Groups (DRG) payment reform on the hospitalization costs of aplastic anemia patients admitted to a tertiary hospital in Jiangsu Province from January 2021 to December 2023, and to analyze the impact of DRG group coding on out-of-pocket expenses outside of health insurance. Methods Data from 809 eligible patients were collected, including 112 in the DRG group and 697 in the non-DRG group. This study innovatively applied propensity score matching (PSM) to evaluate the cost control effect of DRG on non-surgical chronic hematological diseases, , balancing baseline differences between the two groups, and Wilcoxon rank sum test was employed to compare cost differences; For the first time, a Beta regression model was used to deeply analyze the heterogeneous impact of different DRG group codes on patients\' out-of-pocket ratios, with out-of-pocket expenses as the dependent variable and DRG group coding as the independent variable. Results After PSM, 336 patients were included (112 in the DRG group and 224 in the non-DRG group). The median total medical expense in the DRG group was 7013.54 yuan, significantly lower than the 11481.16 yuan in the non-DRG group (P<0.05); there were significant differences in detailed expenses such as Western medicine costs and laboratory fees between the two groups (P<0.05). Beta regression showed that different DRG group codes had a significant impact on out-of-pocket expenses outside of health insurance (P<0.05), with the highest marginal effect observed in the QS35 group (0.2206). Conclusion This study fills the research gap of DRG payment reform in pediatric hematological diseases, confirming that DRG has a significant cost control effect on hospitalization costs of aplastic anemia patients. However, the heterogeneity of out-of-pocket ratios among different DRG groups suggests the need for optimized grouping strategies, providing empirical evidence for formulating precise DRG payment policies in children\'s specialty hospitals.

Keywords： DRG payment reform aplastic anemia hospitalization costs propensity score matching Beta regression Medical coverage