Health Professionals Information for Diagnostics Related Groups (DRGs) with the Use of a Website.

INTRODUCTION: The aim of this research is to inform the health professionals about the ways of introducing and operating the the Diagnosis Related Groups (DRG's) system in the Hellenic National Health System, through the use of the development technologies. An effort is also made to explore the main dimensions of the implementation of the DRG's system, in specific European-Countries that have both adopted the public coverage schemes and the Bismarck health insurance institutions for countries with extensive experience in their implementation.
MATERIAL AND METHODS: A review of the literature was attempted to investigate the ways of financing of the health services, and of the identification and functionality of the DRG's as well as of the methods used by European countries to investigate this prospective compensation system.
RESULTS: The efficient application of DRGs gives the possibility to improve the economic management of Greek hospitals by retaining the costs and consequently contributing to the wise and effective management of hospital expenses. A short training of health professionals on the importance of DRGs in the effective running of Greek hospitals, led to the development of a website. This website will give information on this new method of pricing of hospital health services provided, and will contribute to the overall improvement of health services.
CONCLUSION: Introduction of DRGs, in Greek hospitals will establish a positive condition to solve many emerging health issues and to improve the overall functionality of the health system. Additionally, with the proper implementation of the DRG;s, the financial management of the Greek hospitals, can be improved by keeping the costs down through the proper utilization of the available resources.

1. INTRODUCTION

The DRGs constitute of a system of prospective compensation of hospital health services. It was first introduced in the early 80s and then was adopted by other european countries which tried to run it according to their needs.. In Greece, was introduced for the first time at the end of 2011, as an alternative option for the integrated hospital care and it has being implemented so far to reduce hospital costs. Greece is one of the last countries in Europe to adopt the introduction of DRGs in the National Health System, which proved to be a difficult but inevitable task for the reduction of costs (1).

The issue of funding, allocating resources and containing the deficits of the National health system is a major and timeless problem that has, however, taken tragic dimensions and has always being at the heart of the desirable reforms.

Financing health services is the cornerstone of the health system and concerns both the payer and the mechanisms and criteria by which the health services are financed.. It is conceivable that in the midst of the economic recession the reduction of expenses and their proper management was in the past and is still nowadays the primary objective for the economic survival of the health system in Greece. As a matter of fact, the reforms that had to be achieved in the long run were implemented in a very short time, due to the pressures of the Troika, (an auditing system) (1).

Such a reform in the way in which Greek hospitals are financed by the introduction of DRGs is of great interest to the hospital sector, as there is a gradual adoption of DRG’s at a global level, based on patient mix and the process of the advanced financing of the provided health services. It is also important to mention that the basic policy criteria that health services financing should take into account is equality of access, efficiency and effectiveness of services using special indicators.

In Greek hospitals, this is a major problem as the use of a fixed daily rate cost for services provided in hospitals that integrates indiscriminatively heterogeneous administrative, health and other costs into one price is not an objective criterion for measuring the efficiency of the health services provided (1, 2).

The aim of this research is to inform the health professionals about the ways of introducing and operating the DRG’s system in the Hellenic National Health System, through the use of the development technologies. An effort is also made to explore the main dimensions of the implementation of the DRG’s system, in specific European-Countries that have both adopted the public coverage schemes and the Bismarck health insurance institutions for countries with extensive experience in their implementation (2, 3).

2. MATERIALS AND METHODS

A review of the literature was attempted to investigate the ways of financing of the health services, and of the identification and functionality of the DRG’s as well as of the methods used by European countries to investigate this prospective compensation system. An additional goal was to investigate the efforts made by the Greek health system to implement DRG;s and a final goal was the development of an informative website. Specifically, the user can obtain information on the introduction of DRG’s in the health systems of selected European countries as well as in Greece. Additionally, in the website will be mentioned the general benefits of DRG;s and the role and usefulness of them in the health system nowadays (3, 4).

3. RESULTS

The efficient application of DRGs gives the possibility to improve the economic management of Greek hospitals by retaining the costs and consequently contributing to the wise and effective management of hospital expenses. Due to the economic recession in Greece, the fundamental objective of the National Health System was the reduction of costs, that led to curtailments of the hospital budgets. The consequences of this reduction created problems regarding the optimal function of the hospitals. A short training of health professionals on the importance of DRGs in the effective running of Greek hospitals, led to the development of a website. This website will give information on this new method of pricing of hospital health services provided, and will contribute to the overall improvement of health services, offered in the hospitals (4, 5).

4. DISCUSSION

The DRG’s is an attempt to introduce a prospective financing and compensation system of specific health care services provided in Greek hospitals. Despite the fact that similar financing systems have been introduced in different health systems worldwide (6-9), in Greece early efforts to adopt DRG.s have partly succeeded, and therefore laborious interventions are needed to fulfill the overall efficient functionality of DRGs. With the introduction of DRGs in the National Health System in Greece, major changes have occurred in the production of health services, in relation to different kinds of health insurances covering both patients and health professionals in relation to minimal existing resources with which health personnel is obliged to work and perform efficiently. It is a fact that hospitals, transferred the costs of the drugs, the tests, the health resources and the medical appliances used to public and private insurance companies, with a fixed daily rate, which is a complicated procedure not taking into account the quantity and the prices of drugs and medical appliances used. Hopefully, the introduction of DRGs, in Greek hospitals will establish a positive condition to solve many emerging health issues and to improve the overall functionality of the health system.

Additionally, with the proper implementation of the DRG;s, the financial management of the Greek hospitals, can be improved by keeping the costs down through the proper utilization of the available resources. It is also important to mention that the DRG’s have not been introduced in the National Health System in Greece in a proper way, but in a more rapid pace, without the adequate training of the health staff, as was done in other countries. This has led to different kinds of problems which at the beginning impeded the smooth functionality of DRG’s in Greece (5, 10).

5. CONCLUSION

In the future, it will be attempted to enrich the electronic website with new elements deriving from data coming through evaluation of DRG’s. Some suggestions include the following:

Overall evaluation of DRG’s including both the labour and technologies costs.

Installation of modern IT systems in all hospitals.

Creation of groupers and a software customized to Greek data i.e. a shorting algorithm available that would corresponded to various combinations of diagnosis and medical interventions.

Proper adaptation of the ΕΟΠΠΥ for the administrative support and the efficient auditing of the procedures used in DRG’s.

Proper adaptation of DRG’s in the private sector based on efficiency and effective criteria for the optical selection of patients and the cost containment.

Continuous training of health and administrative personnel for the optimal functionality of DRG’s.