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目的:分析疾病诊断相关分组(diagnosis-related groups，DRG)支付方式改革对某市分娩患者流向和费用的影响。方法:利用某市开展DRG支付方式改革的全部13家试点医院2016年10月至2019年12月的新型农村合作医疗患者数据，分析改革前后产妇分娩地点、分娩方式及分娩费用的变化，并用中断时间序列分析三者的变化趋势。结果:产妇到二级医院分娩的比例由改革前(2016年10月至2017年9月)的52.79%(8 246/15 620)增至改革后(2018年4月至2019年12月)的59.83%(21 229/35 485)。二级医院的剖宫产率由改革前的38.25%降至改革后的37.91%，剖宫产次均费用由改革前4226.61元增至4432.67元；三级医院的剖宫产率由改革前的36.03%增至改革后的39.18%，剖宫产次均费用由改革前6363.81元增至7543.29元。结论:某市实行DRG支付方式改革后，分娩服务流向二级医院，剖宫产率的增长放缓，分娩费用仍有增加，但增长趋势放缓。“,”Objective:To analyze the impact of the payment reform of diagnosis related groups(DRG)on the flow direction and cost of delivery patients in a city.Methods:Using the data of new cooperative medical system from all 13 pilot hospitals carrying out DRG payment reform in a city from October 2016 to December 2019, the changes of delivery place, delivery mode and delivery cost before and after the reform were analyzed, and the change trend of the three was analyzed by interrupted time series.Results:The proportion of maternal delivery in secondary hospitals increased from 52.79%(8 246/15 620)before the reform(October 2016 to September 2017)to 59.83%(21 229/35 485)after the reform(April 2018 to December 2019). The cesarean section rate of women in secondary hospitals decreased from 38.25% before the reform to 37.91% after the reform, and the average cost of cesarean section increased from 4226.61 yuan to 4432.67 yuan. The cesarean section rate of women in tertiary hospitals increased from 36.03% before the reform to 39.18% after the reform, and the average cost of cesarean section increased from 6363.81 yuan to 7543.29 yuan.Conclusions:After the implementation of the DRG payment reform in a city, delivery services flowed to secondary hospitals, the growth of cesarean section rate slowed down, and delivery costs continued to increase, but the growth trend slowed down.