Page 99 - 《南京医科大学学报》2026年第2期

南京医科大学学报（社会科学版）京医科大学学报（社会科学版）
第2期 总第133期 南 ·
2026年4月 Journal of Nanjing Medical University（Social Sciences）of Nanjing Medical University（Social Sciences） · 201
Journal

Degree of structure variation and grey relational analysis of
hospitalization costs among malignant tumor patients under DIP

payment

——using a tertiary hospital in Xiangyang city as an example
1，2
1，2
WAN Shuai ，ZHAO Jun ，ZHENG Yangyang 3
1. Center of Health Administration and Development Studies，2. School of Public Health，Hubei University of Medicine，Shiyan
442000；3. Medical Insurance Office，Xiangyang No.1 People’s Hospital Affiliated to Hubei University of Medicine，Xiangyang
441000，China
Abstract：Employing a retrospective cohort study design，this research utilized the degree of structure
variation and grey relational analysis，combined with CPI discount adjustment and the Jonckheere⁃Terpstra trend
test，to evaluate changes in cost composition and resource allocation before and after the implementation of the
diagnosis ⁃ intervention packet（DIP）at a tertiary hospital in Xiangyang with January 2023 as the cutoff point.
Research indicates that in the second year after DIP implementation，the average total cost per case decreased by
24.38% compared to the pre ⁃ reform period，with a 60.81% reduction in consumable costs. Consumable cost
control showed a one ⁃ year delayed response，with the reduction in 2024 exceeding that in 2023 by 27.7
percentage points. From 2020 to 2024，the proportion of drug expenses showed a downward trend，yet maintained
the highest correlation（0.982）. Meanwhile，the proportions of diagnostic and comprehensive medical service fees
increased，respectively，with contribution rates rising. DIP reform drives hospitals to optimize resource allocation
through a cost ⁃ accounting system，thereby significantly reducing the financial burden on malignant tumor
patients. However，an“exceptional case review”mechanism should be established to address the lag in
controlling high⁃cost drug expenses，while preventing clinical risks arising from excessive cost⁃cutting.
Key words：DIP；degree of structure variation；grey relational analysis；malignant tumor