JungKyu Choi
National Health Insurance Ilsan Hopital, South Korea
Title: The accuracy of payment about new-diagnosis related groups in Korea
Biography
Biography: JungKyu Choi
Abstract
Statement of the Problem: Korea set up new Diagnosis Related Group (DRG) as demonstration project in 2009. While there is a 'bundling part' having a per diem score by diagnosis, the 'non-bundled (fee-for-service) items' also exist. DRG consists of about 550 diseases group. DRG is running only in 40 hospitals due to a lack of consensus. Main purpose of study is to identify the change of accuracy of payment by DRG partition as compared with cost.
Methodology & Theoretical Orientation: This study collected inpatient data from a hospital which contains medical information and cost from 2013 July to 2016 June. The accuracy of payment was classified the accuracy of total, bundled, unbundled and non-benefit payment. The accuracy of payment was calculated as payment divided by cost.
Findings: About 24,000 patients were hospitalized annually. The accuracy of total, bundled and unbundled payment increased 7.2%, 14.6%, and 3.8%. However, the accuracy of non-benefit payment decreased 27.3%. The accuracy of bundled payment showed the largest increase.
Conclusion & Significance: The results of study imply that the accuracy of payment was enhanced. The government needs to monitor side effects such as increase of non-covered services. Also, leads to a considerable improvement in the value of cost unit accounting as a strategic play a role in development of DRG