Analysis of the Impact of C-DRG Reform on Hospitalization Costs and Length of Stay in Patients with Lumbar Spinal Stenosis

Objective: This study aims to assess the impact of the Chinese Diagnosis-Related Group(C-DRG) reform on hospitalization costs and length of stay (LOS) in patients with lumbar spinal stenosis (LSS), providing empirical evidence for policy-making. Methods: This study is a retrospective observational study. Data from 914 patients before the implementation of C-DRG and 1,476 patients after its implementation in a medical institution were used. A propensity score matching method was applied to select 1,224 comparable patients for analysis.Independent t-tests and chi-square tests were used for unadjusted comparisons, and generalized linear models (GLMs) were used to assess the adjusted results. Exponential smoothing methods were applied to predict future trends. Results: After the reform, the length of stay in LSS patients significantly decreased (14.28 ±9.92 days vs. 12.14 ± 7.38 days, p < 0.001), while drug costs significantly decreased (p < 0.001). However, examination and treatment service costs increased (p < 0.05). GLM analysis revealed that the C-DRG reform had no significant association with the overall change in hospitalization costs, but had a significant impact on length of stay, drug costs, and diagnostic fees. Trend forecasting suggests that hospitalization costs will remain stable, while the LOS may experience minor fluctuations in the future. Conclusion: The C-DRG reform significantly optimized hospitalization efficiency in LSS patients, reducing drug costs, but attention should be paid to the increasing trend in diagnostic and treatment costs. Ongoing monitoring and improvements in the reform are crucial for achieving an efficient and sustainable healthcare system.