Exploring the cost implications of different treatment modalities for uterine fibroids under the DRG system

This paper, based on data from inpatient medical records with uterine fibroids (ICD-10: D25) from the medical record homepages of secondary and higher-level hospitals in Sichuan Province between 2016 and 2024, investigated differences in medical resource consumption and costs between high-intensity focused ultrasound (HIFU) and traditional surgical treatments under the diagnosis-related group (DRG) system. Cases were classified using the MS-DRG grouper into groups with and without complications or comorbidities (CC/MCC). An XGBoost model was employed to reclassify data for HIFU patients, addressing missing coding. Group validity was assessed using the coefficient of variation (CV) and reduction in variance (RIV). Factors influencing costs were identified via multifactorial regression analysis. Results showed that in the group without CC/MCC, HIFU treatment significantly reduced the length of hospital stay, decreased the proportion of consumables costs and medication costs, but increased the proportion of treatment costs. Median hospitalization costs were significantly higher in the CC/MCC group than in the non-CC/MCC group. Multifactorial regression analysis identified length of stay (LOS), HIFU treatment, and CC/MCC grouping as key cost drivers. Additionally, costs for patients covered by Urban Employee Basic Medical Insurance and Commercial Health Insurance were significantly higher than those with other payment types. This paper confirms the effectiveness of DRG grouping in reflecting resource consumption disparities and reveals the potential of HIFU technology for optimizing medical resource allocation. Recommendations include promoting HIFU adoption, optimizing medical insurance payment policies, and strengthening hospital management to achieve dual goals of cost control and healthcare quality improvement. The findings provide empirical evidence for DRG payment reform and the selection of uterine fibroid treatment modalities.