The compatibility of diagnosis-intervention packet with the individualized treatment paradigm of traditional Chinese medicine: an analytical study

Background Traditional medicine (TM), including Traditional Chinese Medicine (TCM), serves as a vital component of global healthcare, yet lags behind modern medicine in standardized evaluation and payment model compatibility. In China, TCM's unique paradigm—centered on syndrome differentiation and non-surgical therapies—faces challenges under the Diagnosis-Intervention Packet (DIP) payment reform. However, systematic evidence on how DIP affects medical expenses across different levels of TCM service utilization remains scarce. This study aims to quantify DIP's effects on medical expenses between different groups, and to provide evidence for adjusting DIP policies based on TCM hospital characteristics. Method We conducted a multiple-group interrupted time series analysis (MGITSA) on outcome variables reflecting hospitalization costs and TCM service structures, using a dataset containing 48,398 inpatient records from a TCM hospital in City C spanning from January 2018 to January 2021. The dataset included 4,343 records for the High-TCM group and 44,055 records for the Low-TCM group. Results MGITSA indicated that after DIP implementation, the High-TCM group experienced significant increases in both hospitalization costs ( p < 0.01) and out-of-pocket payments ( p < 0.05). Conversely, the low-TCM group experienced significant decrease in hospitalization cost ( p < 0.01) and Chinese herbal decoction pieces ( p < 0.01). Conclusion DIP exerts distinct short-term effects: the high-TCM group maintained cost stability, while the low-TCM group exhibited cost inflation. Policy adjustments, such as differential DIP scoring based on TCM treatment rates, are needed to enhance compatibility and support TCM's sustainable development.