China Names 130 Diseases for Inclusion in DRG-Based System

Up until now, China has only had a few Diagnosis-Related Groups (DRGs), and they have not been a factor in China’s healthcare scheme. However, in February 2018, China’s Ministry of Human Resources and Social Security (MoHRSS) released a list of 130 diseases recommended for inclusion in Diagnosis-Related Groups (DRGs) for health insurance payments. The list includes a large number of cancers and heart diseases, as well as surgical procedures such as cataract surgery and kidney transplants. Next, local governments need to select at least 100 diseases according to their budgets and needs.

China is introducing DRG-based budgeting for health insurance in an effort to reduce waste. Under this system, hospitals are reimbursed for each case in a given disease category with a fixed fee, regardless of the actual cost. DRG budgeting is currently being used only for diseases that require surgical treatment, with other treatment categories to be added gradually.