The Adaptability and Limitations of General Equilibrium Theory in the Pricing Formation of DRG/DIP Payments under Healthcare Insurance Systems
Li Wei
Qiao Yan
Xu Lulu
Lu Wei
Wang Nongchao
Wang Bo
Gu Hai
Chen Hongdou
Abstract：The reform of healthcare payment systems,particularly through Diagnosis-Related Groups(DRG)/Diagnosis-Intervention Package(DIP),seeks to enhance the efficiency of medical resource allocation by establishing evidence-based pricing mechanisms.General equilibrium theory serves as a foundational framework for understanding price formation and systemic equilibrium.However,structural characteristics inherent to healthcare markets,including pronounced information asymmetry,principal-agent dilemmas,and regulatory constraints,expose critical limitations in applying equilibrium-based paradigms.Combining policy practice and theoretical models,it systematically analyzes the applicability and boundaries of the general equilibrium theory in the formation of DRG/DIP disease prices,and proposes improvement paths such as dynamic adjustment mechanisms and policy coordination.
Keywords：general equilibrium theoryDiagnosis-Related GroupsDiagnosis-Intervention Packageprice formation machanism
Publication Date：2025-12-05
Online Publishing Date：2026-01-05(First online date of this platform, not the publication date of the document)
Pages：4( 1-3,8 )