• Overarching Findings • DRG/DIP payment reforms transition hospitals from volume-driven “revenue centers” to value-based “cost centers,” enhancing cost containment and operational efficiency by approximately 37%. • Despite significant heterogeneity (I² > 50%) across 49 included studies, consistent improvements in resource utilization and process optimization were observed, particularly in tertiary hospitals. • Mechanistic Insights • The shift to fixed-case payments under DRG/DIP creates dual pressures for cost control and quality maintenance, often leading to potential cost-shifting risks (e.g., increased out-of-pocket expenses). • Integration of clinical pathways with activity-based costing enables precise cost tracking and standardization, reducing waste while preserving care quality. • Methodological Rigor and Synthesis • A structured narrative synthesis was employed due to substantial methodological heterogeneity. Sensitivity analyses confirmed the robustness of primary findings, with effect estimates varying by 50%), we employed narrative synthesis rather than meta-analysis. : Our analysis included 49 studies (n = 15,392 participants). DRG/DIP implementations improved cost containment and process efficiency, with approximately 37% enhancement in resource utilization metrics. These findings demonstrate consistent improvements across diverse healthcare settings, although substantial heterogeneity precluded quantitative pooling. : DRG/DIP payment reforms show significant potential for enhancing hospital lean operations and cost performance. Consequently,future research should prioritize standardized metrics and robust evaluations to bridge policy-clinical gaps.
Wang et al. (Wed,) studied this question.