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KMID : 0377220020270010166
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Medical Journal of Chosun Univercity
2002 Volume.27 No. 1 p.166 ~ p.176
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Comparative Analysis of Medical Treatment Practices and Medical Costs between DRG Payment System and Fee For Service System
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Kim Yeon
Seo Jung-A
Chung Young
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Abstract
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Objectives: The purposes of this study were to analyze the quantity of medical services and to identify the factors that create differences in medical costs, medical treatment practices, and the differences in medical costs.
Methods: A university hospital which uses the DRG payment system was selected to study. The subjects were the DGRs patients who were discharged from this hospital in the months of January, March, and May of 2000, and January, March, and May of 2001. Data were collected from medical care specification sheets, medical treatment records, and medical service charges.
Results: 1. The distribution of subjects in each disease group was 22 DRGs in 8 disease groups among the current 41 DRGs in 8 disease groups. 2. On the medical treatment practices the following 6 factors were identified as significant factors of total costs of DRG: injection costs, operation and delivery costs, bed costs, medication &rescription costs, anesthetic costs and radiation costs. However, there were small differences among medical departments. 3. On the share of medical costs, the number of cases for which patients have to pay the costs decreased in 13 DRGs and the number of cases for which the insurance unions have to pay the costs increased in all 4 departments and in all 14 DRGs. 4. In the 3 departments and 11 DRGs the total DRG costs were higher than the costs for FFS. The difference between the total DRG costs and the total FFS costs were decreased in the year 2001 compared to the difference in the year 2000.
Conclusion: As a result, the burden of medical costs for patients and their families has decreased. Therefore, extended application DRG in the practice is necessary. considering the decrease of the difference between the total DRG costs and the total FFS costs and the adequacy of the quantity of medical services. The fairness of the costs should be analyzed for patient groups where the FFS costs appeared to be higher than the total DRG costs. Strategies to eliminate the unnecessary medical services to control medical costs are necessary. Moreover, the proper reimbursement strategies are needed to disseminate the DRG- PPS.
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KEYWORD
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DRG-PPS, Dignosis Related Group-Prospective Payment System, FFS, Fee-For-service
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