Impacts of a new diagnosis-related group point payment system on children's medical services in China: Length of stay and costs.

BACKGROUND: Paediatric healthcare is always highlighted in medical and health care system reform in China. Zhejiang Province established a new diagnosis-related group (DRG) point payment reform in 2020 to regulate provider behaviours and control medical costs. We conducted this study to evaluate impacts of the DRG point payment policy on provider behaviours and resource usage in children's medical services. METHODS: Data from patients' discharge records from July 2019 to December 2020 in Children's Hospital, Zhejiang University School of Medicine were collected for analysis. We employed the interrupted time series approach to reveal the trend before and after the DRG point payment reform and the difference-in-differences analysis to estimate the independent outcome changes attributed to the reform. RESULTS: We found that the upward trend of length of stay slightly slowed, and the total costs began to decrease at the post-policy stage. Although independent effects of the reform were not presented among the whole sample, the length of stay and hospitalisation costs of moderate-hospital-stay paediatric patients, non-surgical patients, and infant patients were found to decrease rapidly after the reform. CONCLUSION: DRG point payments can changed the provider behaviours and eventually reduce healthcare resource usage in children's medical services.

Estimating environmental value losses from earth materials excavation and infilling for large-scale airport construction: a case of Dalian Offshore Airport, Dalian, China.

Large-scale airport construction removes large quantities of earth materials, resulting in serious environmental pollution and ecosystem damage. However, studies of environmental concerns caused by the materials used in airport construction are still preliminary, and those case studies on the impacts of large-scale offshore airport development are very limited. China's Dalian Offshore Airport is considered here to study the environmental value loss from 240 million m3 of materials excavations and 21 km2 of artificial island infillings. The findings show that the calculated annual environmental value loss for the development of the Dalian Offshore Airport is approximately US$7.75 million, including US$1.81 million and US$1.47 million of direct economic loss of timber resources and marine biology resources, respectively, and US$1.53 million and US$2.79 million value losses of forest and marine ecosystem services damaged caused by materials excavation and infilling, respectively. The conclusions of this study provide an important foundation to quantitatively analyse the environmental impact of the Dalian Offshore Airport's development and can be used as a reference for similar engineering and environment impact assessment programs.