Author(s)

Zhao Jiarui ¹

Affiliation(s)

¹ The First Affiliated Hospital of Harbin Medical University, 150001, Harbin, Heilongjiang, China

Corresponding Author

Zhao Jiarui

ABSTRACT

This article explores the effective path of fine control of disease costs in public hospitals under the background of DRG (Diagnosis Related Group) payment reform, providing a theoretical framework and practical reference for hospitals to transform from scale expansion to connotation development. Integrating the perspectives of health economics, management science and clinical medicine, a theoretical framework covering the construction of disease cost accounting system, the development of cost control tools and the innovation of performance evaluation mechanism was constructed. Taking the People's Hospital of A City as a case, the activity-based costing method was adopted to reconstruct the cost flow, the intelligent system of clinical pathway-cost linkage and the dynamic monitoring platform were deployed, and the "3+1" multi-dimensional performance evaluation mechanism was implemented to carry out a two-year empirical study. After the implementation, the average cost of DRG group in A Hospital decreased from 5743 yuan to 4987 yuan, with a decrease of 13.2%, the surplus rate of medical insurance settlement increased from 1.2% to 6.8%, the proportion of deficit diseases decreased from 37.5% to 14.2%, and the implementation rate of clinical pathway jumped from 51% to 82%. Taking GB25 group as an example, the proportion of high-value consumables decreased by 9.3 percentage points, the complication rate decreased from 4.1% to 3.3% (P<0.05), and the patient satisfaction increased to 92.5 points. Data granularity determines control accuracy, clinical participation determines landing depth, and policy adaptability determines sustainability. Through the closed-loop management of "calculation-feedback-iteration", the cost control and medical quality can be improved.

KEYWORDS

DRG payment; Disease cost; Fine control; Activity-based costing; Clinical pathway

CITE THIS PAPER

Zhao Jiarui. Practice Research on Fine Control of Disease Cost in Public Hospitals under the Reform of DRG Payment Mode. Social Medicine and Health Management (2026). Vol. 7, No.1, 100-107. DOI: http://dx.doi.org/10.23977/socmhm.2026.070114.

REFERENCES

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