IDEAS home Printed from https://ideas.repec.org/a/spr/pharmo/v4y2020i1d10.1007_s41669-019-0146-z.html
   My bibliography  Save this article

An Evaluation of Diagnosis-Related Group (DRG) Implementation Focused on Cancer DRGs in Greek Public Hospitals

Author

Listed:
  • Panos Panagiotopoulos

    (National and Kapodistrian University of Athens (UOA))

  • Nikos Maniadakis

    (National School of Public Health (NSPH))

  • George Papatheodoridis

    (National and Kapodistrian University of Athens (UOA))

  • Dimitris Pektasidis

    (National and Kapodistrian University of Athens (UOA))

Abstract

Objectives 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. The aim of this stage was identification of the total operating costs and the average cost per patient day for each Internal Medicine Department of the ‘Hippokration’ General Hospital of Athens during the period 2014–2015. The final cost drivers were identified using the concept of cluster-related incidents in the hospital. 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. In addition, under the scope of this study, two proposed models for the KEN-DRG price recalculation were developed, based on the average estimated cost of hospitalization for the sample incidents, which could improve the existing reimbursement system for Greek hospitals in the medium term. 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.

Suggested Citation

  • Panos Panagiotopoulos & Nikos Maniadakis & George Papatheodoridis & Dimitris Pektasidis, 2020. "An Evaluation of Diagnosis-Related Group (DRG) Implementation Focused on Cancer DRGs in Greek Public Hospitals," PharmacoEconomics - Open, Springer, vol. 4(1), pages 61-69, March.
  • Handle: RePEc:spr:pharmo:v:4:y:2020:i:1:d:10.1007_s41669-019-0146-z
    DOI: 10.1007/s41669-019-0146-z
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s41669-019-0146-z
    File Function: Abstract
    Download Restriction: no

    File URL: https://libkey.io/10.1007/s41669-019-0146-z?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Magnussen, Jon & Solstad, Kjell, 1994. "Case-based hospital financing: the case of Norway," Health Policy, Elsevier, vol. 28(1), pages 23-36, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Cots, Francesc & Elvira, David & Castells, Xavier & Dalmau, Eulalia, 2000. "Medicare's DRG-weights in a European environment: the Spanish experience," Health Policy, Elsevier, vol. 51(1), pages 31-47, February.
    2. Anni Ankjær-Jensen & Pernille Rosling & Lone Bilde, 2006. "Variable prospective financing in the Danish hospital sector and the development of a Danish case-mix system," Health Care Management Science, Springer, vol. 9(3), pages 259-268, August.
    3. Rozalia Nistor & Costel Nistor & Mihaela-Carmen Muntean & Ludmila Daniela Manea, 2013. "Information And Communication Technology In Health Services In Romania," Risk in Contemporary Economy, "Dunarea de Jos" University of Galati, Faculty of Economics and Business Administration, pages 106-114.
    4. Duckett, Stephen J., 1995. "Hospital payment arrangements to encourage efficiency: the case of Victoria, Australia," Health Policy, Elsevier, vol. 34(2), pages 113-134, November.
    5. Mooney, Gavin, 2002. "The Danish health care system: it ain't broke... so don't fix it," Health Policy, Elsevier, vol. 59(2), pages 161-171, January.
    6. Vrangbaek, Karsten & Bech, Mickael, 2004. "County level responses to the introduction of DRG rates for "extended choice" hospital patients in Denmark," Health Policy, Elsevier, vol. 67(1), pages 25-37, January.
    7. Linna, Miika & Hakkinen, Unto & Magnussen, Jon, 2006. "Comparing hospital cost efficiency between Norway and Finland," Health Policy, Elsevier, vol. 77(3), pages 268-278, August.
    8. Mikkola, Hennamari & Keskimaki, Ilmo & Hakkinen, Unto, 2002. "DRG-related prices applied in a public health care system--can Finland learn from Norway and Sweden?," Health Policy, Elsevier, vol. 59(1), pages 37-51, January.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:pharmo:v:4:y:2020:i:1:d:10.1007_s41669-019-0146-z. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.