中文摘要：

目的评价三明市公立医院支付方式改革的实施效果。方法利用间断时间序列分析方法，比较DRGs支付方式改革前后三明市21家县级及以上公立医院的平均住院日、人均住院费用、次均门诊费用、住院医务性费用占比及住院药占比的变化趋势。结果改革前后平均住院日保持原有趋势；三级医院人均住院费用控制效果较差，次均门诊费用呈现“先降后升”的趋势，住院医务性费用占比和药占比改革后降幅较小。结论三级医院整体门诊住院费用增速较快，可能存在不合理的费用转移，住院费用结构趋势放缓，合理性有待判断。

英文摘要：

Objective To evaluate the outcomes of the payment reform at public hospitals in Sanming city. Methods Interrupted time series analysis was used to compare changes of the average days of stay, per capita hospitalization expense, outpatient expense per visit, proportion of medical expense and that of drugs during hospitalization at 21 public hospitals at or above county level before and after the DRGs reform. Results Comparisons before and after the reform found the average days of stay at the original momentum, poor control in curbing the proportion of medical expense and that of drugs during hospitalization, a ＂dropping followed by rising＂ trend in the outpatient expense per visit, and minimal drop of the abovementioned proportions. Conclusions The rapid growth of outpatient and hospitalization costs at tertiary hospitals may be incurred by unreasonable cost transfer, structural trend of hospitalization expense makeup, and rationality pending scrutiny.