Confronting the economic burden of diabetes: Can TCM DRG payment reform in China offer a viable solution? Insights from empirical research in Western China

Background Diabetes poses a major global public health challenge, carrying significant economic implications worldwide. In China, the ongoing implementation of Diagnosis Related Groups (DRG) payment reforms, especially within Traditional Chinese Medicine (TCM) contexts, is critical in improving diabetes patient care and alleviating associated economic burdens. Methods We examined 2,804 hospitalized diabetes patients at Qingyang City Hospital of Chinese Medicine in Gansu Province from 2017 to 2022. Using univariate and interrupted time-series (ITS) analyses, we compared patient visit data, healthcare-related costs, and length of stay pre- and post-DRG reform. Results Following DRG reform at Qingyang City Hospital of Chinese Medicine, significant differences were noted in patients’ age, visit times, type of diabetes, complications and comorbidities, use of Chinese medicine diagnostic and therapeutic equipment, and surgeries and operations, compared with the pre-reform period ( p < 0.05). Post-reform, there was a noteworthy decrease in hospitalization cost and Western medicine cost, and TCM treatment cost ( p < 0.05), while Chinese medicine cost remained stable but the overall cost level increased ( p > 0.05). Additionally, there was a slight reduction in length of stay after the reform, although this change did not reach statistical significance ( p > 0.05). Conclusion DRG reform significantly reduces hospitalization cost, TCM treatment cost, and Western medicine cost for diabetes patients in TCM hospitals. However, its impact on Chinese medicine cost and length of stay is limited. Future reforms should capitalize on the unique strengths of TCM treatment, enhance cost management strategies, and focus on minimizing length of stay and medical expenses while ensuring effective patient care.