Analysis of the Impact of Volume-based Centralized Procurement of Orthopedic Spinal Consumables on Inpatient Costs under the DRG Payment System

Ren Jinwen; Zhu Jiaying; Ding Wenya

Abstract：Objective To investigate the changes in total hospitalization costs and their structure associated with or-thopedic spinal consumables before and after the implementation of volume-based centralized procurement under the DRG payment system.Methods Data were collected from a tertiary Class A hospital for cases related to spinal fu-sion surgery between June 2022 and May 2024.Grey relational analysis,structural change analysis,interrupted time series analysis,and other statistical methods were employed to analyze the differences in total hospitalization costs and cost structures before and after the implementation of volume-based centralized procurement.Results In the month of volume-based centralized procurement implementation,total hospitalization costs and material costs de-creased by 9 520.82 yuan and 9 878.83 yuan,respectively,with statistically significant differences(P＜0.05).From a long-term trend perspective,after volume-based centralized procurement,there was a growing trend in total hos-pitalization costs,material costs,surgical fees,and drug costs,all with statistically significant differences(P＜0.05).In the month of volume-based centralized procurement"implementation,the proportion of material costs in-stantly decreased by 10.8％,while the proportion of surgical fees increased by 4.8％,both with statistically signifi-cant differences(P＜0.001).From a long-term trend perspective,after volume-based centralized procurement,the proportions of material costs and surgical fees remained stable over the long term,without statistically significant dif-ferences(P＞0.05).Conclusion Volume-based centralized procurement"of medical consumables under the DRG pay-ment system has played a certain role in reducing medical expenses and adjusting the cost structure.However,there are still deficiencies in accompanying policies such as the formulation of DRG payment standards and adjust-ments to medical service prices.