Comparative analysis of European systems of homogeneous patient groups
DOI:
https://doi.org/10.24144/2415-8127.2019.60.83-90Keywords:
financing, homogeneous patient groups, OGP, DRG, reimbursement, inpatient care.Abstract
In Europe, depending on the method of reimbursement, there are two basic models of financing of health care facil-ities that provide acute inpatient care under homogeneous patient groups: retrospective payments for hospitalization cases and prospective budgetary allocations. Each model has its own impact on activities of health care facilities. Also, different methods of calculating the actual rate of payment for each group exist. Generally, this rate is equal to the product of the value of the group and the rate of conversion. But both the valuesand the coefficients may differ de-pending on the country and be expressed in different quantities. This further changes the totality and the intensity of the institution incentives. The purpose was to study models of retrospective DRG-based payments for hospitalization cases, their implemen-tation and impact on national health systems in five European countries, namely in the United Kingdom, France, Ger-many, Poland and Hungary. Data from current scientific literature about the model of DRG-based payments have been analyzed using the content analysis, the method of systematic and comparative analysis, and the bibliosemantic meth-od. The main part of the article analyzes characteristics of national healthcare systems of the countries mentioned above: the sources of funding, the features of reimbursement methods for healthcare facilities, the experience of im-plementation of homogeneous patient groups, and current methods of calculating the actual rate of hospitalization case. Also, for each country of this study, the evolution of certain indices of national health care systems under homogene-ous patient groups was noted. A separate section is provided to analyze the intended and unintended consequences that should be anticipated and prevented during the implementation of homogeneous patient group systems. As a result, it was determined that in the countries studied there was a consistent reduction in bed funds and length of stay, while improving the quality of health care.
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