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The development of diagnosis related group system in healthcare

Razvoj sistema skupine primerljivih primerov v zdravstvu

Članek podaja vsebinski in časovni pregled razvoja sistemov plačevanja po skupinah primerljivih primerov. Sistem je bil sprva uveden kot managersko orodje za znižanje stroškov in povečanje učinkovitosti. Sistem plačevanja skupin primerljivih primerov je sledil razvoju medicine in sodeloval v izgradnji sistema kakovosti in varnosti bolnikov. V zadnjih letih so v nekaterih državah že pričeli poplačevati kakovost zdravstvenih izidov. Sodobni trend celostne obravnave bolnikov bo zahteval ponovno prilagoditev sistema plačevanja v zdravstvu.

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Hospital manipulations in the DRG system: a systematic scoping review

References 1. Fetter RB, Thompson JD, Mills RE. A system for cost and reimbursement control in hospitals. Yale J Biol Med. 1976; 49:123-36. 2. Roger France FH. Case mix use in 25 countries: a migration success but international comparisons failure. Int J Med Inform. 2003; 70:215-9. 3. Rosenberg MA, Browne MJ. The Impact of the Inpatient Prospective Payment System and Diagnosis- Related Groups: A Survey of the Literature. North American Actuarial Journal. 2001; 5:84-94. 4. International

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Diagnosis-Related Group Prospective Payment System in Poland – Costs Versus Tariffs: The Case of Inguinal Hernia

. Krasodomska, K. Świetla (ed.), Współczesne uwarunkowania sprawozdawczości i rewizji finansowej , Fundacja Uniwersytetu Ekonomicznego w Krakowie, Kraków, pp. 329-340. Macuda M., 2018, Groupes Homogènes de Malades – vers une efficacité économique: analyse des produits et charges d’exploitation , Revue Internationale des Economistes de Langue Française, vol. 3, no. 1, pp. 114-129. Mihailovic N., Kocic S., Jakovljevic M., 2016, Review of diagnosis-related group-based financing of hospital care, Health Services Research and Managerial Epidemiology, vol. 3, pp. 1

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The Knowledge of Medical Professionals from Selected Hospitals in the Lubelskie Province about Diagnosis-Related Groups Systems

References Busse, R., Geissler, A., Quentin, W., & Wiley, M. (Eds.). (2011). Diagnosis-Related Groups in Europe. Moving towards transparency, effciency and quality in hospitals. Open University Press. World Health Organization 2011 on behalf of the European Observatory on Health Systems and Policies. Retrieved from http://www.euro.who.int/ data/assets/pdf file/0004/162265/e96538.pdf. Charlesworth, A., Davies, A., & Dixon, J. (2012). Reforming payment for health care in Europe to achieve better value (Research report

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Diagnosis-Related Groups (DRG) and Hospital Business Performance Management

Abstract

The goal of this article is to present the possibility of using Diagnosis- Related Groups (DRG) in the hospital management process and to analyse the need for business performance management on the part of hospital management staff. The following research methods were used: literature analysis, case studies, and poll analysis. It is not possible to increase the effectiveness of operation of healthcare entities without increasing the importance of IT systems and using DRG more effectively in the management process. Training users in IT and the use of DRGs is important to achieving hospital effectiveness. The increased importance of analyses and planning in a hospital should be reflected in the organisational structure of service providers. Hospital controllers should have a similar role to those present in most companies in other industries.

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Describing Serbian Hospital Activity Using Australian Refined Diagnosis Related Groups: A Case Study in Vojvodina Province

Accessed March 10th, 2019 at: https://openknowledge.worldbank.org/handle/10986/3061 3 Palmer G, Reid B. Evaluation of the performance of diagnosis-related groups and similar casemix systems: methodological issues. Health Serv Manage Res. 2001;14(2):71–81. doi: 10.1258/0951484011912564 . 11373998 Palmer G Reid B Evaluation of the performance of diagnosis-related groups and similar casemix systems: methodological issues Health Serv Manage Res 2001 14 2 71 81 10.1258/0951484011912564 4 Geissler A, Quentin W, Scheller-Kreinsen D

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Estimating uncompensated medical care cost as a result of adverse events in a university hospital in Thailand

concerns over the financial sustainability of public hospitals, and even UHC programs. Although any treatment complications during hospital stay might increase relative weights for inpatient reimbursement under the Thai diagnosis-related-group (Thai-DRG) system, there was no evidence for whether any additional payments would be adequate for compensating the increased costs resulting from AEs. Therefore, the present study aimed to explore whether there might be any uncompensated costs of medical care associated with AEs in a hospital, using standardized cost based on Thai

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Relationship between the cost of weights and the success of hospital performance from 2006 to 2009

Povezava med višino cene uteži in uspešnostjo poslovanja bolnišnic v letih 2006-2009

Cilj poslovanja bolnišnic, ki so organizirane kot javni zavodi, ni ustvarjanje dobička, ampak izvajanje dejavnosti, za katero so bile ustanovljene. Z izpeljavo tega načela lahko predpostavimo, da bodo bolnišnice stremele k doseganju minimalnega presežka prihodkov nad odhodki, in sicer ne glede na višino sredstev, ki jih prejmejo. Akutna bolnišnična obravnava se plačuje po sistemu skupin primerljivih primerov (SPP). V sistemu SPP zaradi zgodovinskega toka dogodkov bolnišnice prejemajo različno visoka sredstva za enake opravljene storitve, kar lahko vpliva na uspešnost njihovega poslovanja. Izbrani vzorec zajema 15 bolnišnic, ki so organizirane kot javni zdravstveni zavodi in izvajajo zdravstveno dejavnost le na sekundarni ravni. Obstaja povezava med višino cene uteži, ki jo posamezni izvajalec prejme po sistemu SPP, in presežkom prihodkov nad odhodki posameznega izvajalca (Spearmanov rho = 0,52, p=0,000). Zanimivo pa je dejstvo, da je ob upoštevanju enotne cene uteži in prilagoditvi izkazov nanjo poslovanje bolnišnic bolj neenakomerno kot ob različnih cenah uteži, standardni odklon presežka prihodkov pa se poveča za 59 %. Glede na navedeno je treba razmisliti o dokončnem poenotenju cen uteži v slovenskih bolnišnicah.

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The cost of systemic therapy for metastatic colorectal carcinoma in Slovenia: discrepancy analysis between cost and reimbursement

Abstract

Background. The aim of the study was to estimate the direct medical costs of metastatic colorectal cancer (mCRC) treated at the Institute of Oncology Ljubljana and to question the healthcare payment system in Slovenia.

Methods. Using an internal patient database, the costs of mCRC patients were estimated in 2009 by examining (1) mCRC direct medical related costs, and (2) the cost difference between payment received by Slovenian health insurance and actual mCRC costs. Costs were analysed in the treatment phase of the disease by assessing the direct medical costs of hospital treatment with systemic therapy together with hospital treatment of side effects, without assessing radiotherapy or surgical treatment. Follow-up costs, indirect medical costs, and nonmedical costs were not included.

Results. A total of 209 mCRC patients met all eligibility criteria. The direct medical costs of mCRC hospitalization with systemic therapy in Slovenia for 2009 were estimated as the cost of medications (cost of systemic therapy + cost of drugs for premedication) + labor cost (the cost of carrying out systemic treatment) + cost of lab tests + cost of imaging tests + KRAS testing cost + cost of hospital treatment due to side effects of mCRC treatment, and amounted to €3,914,697. The difference between the cost paid by health insurance and actual costs, estimated as direct medical costs of hospitalization of mCRC patients treated with systemic therapy at the Institute of Oncology Ljubljana in 2009, was €1,900,757.80.

Conclusions. The costs paid to the Institute of Oncology Ljubljana by health insurance for treating mCRC with systemic therapy do not match the actual cost of treatment. In fact, the difference between the payment and the actual cost estimated as direct medical costs of hospitalization of mCRC patients treated with systemic therapy at the Institute of Oncology Ljubljana in 2009 was €1,900,757.80. The model Australian Refined Diagnosis Related Groups (AR-DRG) for cost assessment in oncology being currently used is probably one of the reasons for the discrepancy between pay-outs and actual costs. We propose new method for more precise cost assessment in oncology.

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Evaluation of Clinical Diagnostic Tests in Dermatology

;155:1006-12. 13. Roger France FH. Case mix use in 25 countries: a migration success but international comparisons failure. Int J Med Inf 2003;70:215-9. 14. Hensen P, Furstenberg T, Luger TA, Steinhoff M, Roeder N. Case mix measures and diagnosis-related groups: opportunities and threats for inpatient dermatology. J Eur Acad Dermatol Venereol 2005;19:582-8.

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