Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 15 1 2026 12 01 Association Between China’s DRG Reform and Value-Based Healthcare Orientation: Evidence From Inpatients With Acute Myocardial Infarction and Cancer in Tertiary Hospitals in Western China 1 13 4895 10.34172/ijhpm.9669 EN Haoran Li School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, China School of Public Health, Imperial College London, London, UK 0009-0008-6781-7134 Fukun Zhu School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, China 0009-0000-9021-7825 Tao Xie School of Political Science and Public Administration, Wuhan University, Wuhan, China 0000-0003-2169-5692 Ning Zhang Vanke School of Public Health, Tsinghua University, Beijing, China 0000-0001-5841-4933 Austen El-Osta School of Public Health, Imperial College London, London, UK 0000-0002-8772-4938 Zhonghan Wang School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, China 0000-0003-3456-6611 Ying Mao School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, China 0000-0002-8271-2524 Journal Article 2025 12 09 Background Implementing diagnosis-related groups (DRGs) reform under the guidance of value-based healthcare (VBH) is of great significance for China to curb the rapid rise of medical costs and promote the allocation and utilization of medical resources. However, current research evaluating the effectiveness of China’s DRGs reform lacks a valuebased oriented approach to healthcare and has not yet explored whether different types of diseases and population characteristics will affect policy implementation. Methods A total of 16 564 acute myocardial infarction (AMI) and 74 356 cancer inpatients were included in this singlecenter study during 2018-2022. Interrupted time series models were used to estimate post-reform level and slope changes. Exploratory subgroup analyses were conducted by gender, age, and disease type. Hospital-level outcomes included riskadjusted success per cost (SPC), cost per success (CPS), and net monetary benefit (NMB). Individual-level outcomes included total hospitalization cost, length of stay, mortality, successful outcomes, and 30-day readmission. Results DRG reform was associated with changes in VBH indicators, with AMI mainly showing slope changes and cancer mainly showing level changes. However, individual-level analyses showed that some clinical outcomes did not improve consistently, which differed from the hospital-level results. Conclusion The findings suggest that DRG reform was associated with changes in selected hospital-level VBH indicators, while some individual-level clinical outcomes did not show consistent improvement. Future payment reform should combine disease-specific clinical pathways, stronger risk adjustment, and routine monitoring of patient-level quality outcomes, especially for acute and high-risk conditions.

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