An Evaluation of Diagnosis-Related Group (DRG) Implementation Focused on Cancer DRGs in Greek Public Hospitals
An Evaluation of Diagnosis-Related Group (DRG) Implementation Focused on Cancer DRGs in Greek Public Hospitals (Springer).
The main aims of this study were to evaluate the Greek version of the diagnosis-related group reimbursement system (KEN-DRG) and to compare the KEN-DRG prices with the average actual cost of each group of study cases. Along with other aspects, the differences between the KEN-DRG average length of stay (ALOS) and the actual ALOS was evaluated in selected cases.
Methods
In the first part of this study, the top-down costing approach was selected in
order to break down the total operating costs of the hospital, by hospital
department. [...] In a subsequent stage, the 13 most
frequent cancer KEN-DRG prices charged by Internal Medicine Departments were
selected as a sample for further data analysis.
Results
With regard to the costing of the oncological KEN-DRG, the present study
illustrates that a majority of the current reimbursement rates for oncological
KEN-DRG codes are under-reimbursed, taking into account the actual costs of
hospitalization for each group of cases. The results also reveal that the ALOS
of the KEN-DRG does not reflect the actual ALOS in the sample of cases
examined. [...]
Conclusions
The KEN-DRG payment system that was implemented in Greece for the first time in
2012 needs redesigning in terms of the true cost of hospital services and the
actual cost of each patient’s treatment. With regard to the existing KEN-DRG
reimbursement system, the current study suggested the use of a DRG price
calculation model that consists of a relative weight factor and a base price,
based on a real cost calculation process on an annual basis. Moreover, it
should be stressed that the present study, as well as other related studies,
make it possible to know the actual cost of hospitalization, and can contribute
to the creation of a cost database over time at the level of hospitals or
specific clinical departments.
Quelle: Springer, 20.05.2019