The synergistic effect of DRG payment joint chest pain center on hospitalization costs, hospital days and medical quality of care in patients with acute coronary syndrome

Diagnosis-related grouping (DRG) payment has been widely introduced into the management of patients with acute coronary syndrome (ACS) in chest pain centers, but its impact on hospital costs, hospital days, and medical quality in ACS patients, especially with the construction of chest pain centers, has not been fully studied. In this study, 12,760 consecutive patients were diagnosed with ACS in the chest pain center of our hospital from 1 January 2015 to 31 June 2023. Through multivariate logistic regression and tendency score matching analysis, we explored the before and after differences in hospitalization costs, hospital days, and quality of ACS during the three key time periods (before the standard construction and implementation of DRG payment, after the construction of the CPC specification and before the implementation of DRG payment, after the standard construction and implementation of DRG payment). After the implementation of DRG payment, the proportion of hospitalization costs (β = −7950.28, 95% CI −8861.51, −7039.06, p < 0.001), hospitalization days (β = −1.57,95% CI −1.77, −1.36, p < 0.001), and readmission for heart failure ( HF) (OR = 0.53,95% CI 0.43,0.65, p < 0.001) of ACS patients all decreased. At the same time, we also found that the implementation of DRG payment and the standardized construction of CPC played a synergistic effect in the management of ACS patients, which significantly reduced hospitalization costs, hospitalization days and the proportion of readmission for HF in ACS patients (p < 0.001). DRG payment can reduce hospitalization costs, hospitalization days, and the proportion of HF readmissions in patients with ACS. At the same time, the implementation of DRG payment and the standard construction of CPC have a synergistic effect on the improvement of medical quality of ACS patients. Hospitalization costs, hospitalization days, and the proportion of readmissions for HF were significantly reduced. This study provides comprehensive empirical evidence on the impact of DRG payment reform on hospitalization costs, hospitalization days, and medical quality in patients with acute coronary syndrome (ACS). By using a large dataset and advanced statistical methods such as multivariable logistic regression and propensity score matching, the research offers robust findings that highlight the effectiveness of DRG reform. The study underscores the synergy between DRG payment implementation and the standardization of chest pain centers, showcasing significant improvements in medical quality and reductions in costs and readmission rates for heart failure. These findings contribute valuable insights for policymakers and healthcare administrators aiming to enhance cost efficiency and quality of care in ACS management.