Abstract: Objective： To study the influence of contractual medical association on inpatient service performance. Methods: The data came from “Database of Inpatient Record” administered by Department of Medical Insurance. Using diagnosis related groups (DRG) as the tool of risk-adjustment, the third-tier general hospitals and second-tier general hospitals in medical alliance as the intervention group, and the average level of the same grade local hospitals as the control group, the influence of medical alliance on inpatient service performance was evaluated. The difference in difference (DID) method was used for the data analysis. The assessing indicators included the number of DRG group, case mix index (CMI), the total weight, cost efficiency index and time efficiency index. Results: After the establishment of medical association, compared with the average level of the same grade local hospitals, in the third-tier general hospitals of medical alliance, the growth rate of the total weight had declined, and cost efficiency index had increased, while in the second-tier general hospitals of medical alliance, the CMI value had declined, and the cost efficiency index had increased. Conclusion: Contractual medical association played a role of triage patients, and improved the service levels and management efficiency of the second-tier general hospitals.

Key words: Contractual medical association, Hospitalization, Health services, Performance, Diagnosis related groups