| Summary: | Background/Aim. Global budget per calendar year is a traditional method of
funding hospitals in Serbia. Diagnose related groups (DGR) is a method of
hospital payment based on classification of patients into groups with
clinically similar problems and similar utilization of hospital resources.
The aim of this study was to compare current methods of hospital services
payment with the projected costs by DRG payment method in urology. Methods.
The data were obtained from the information system used in the Clinical
Hospital Center “Dr. Dragiša Mišović” - Dedinje in Belgrade, Serbia. The
implemented hospital information system was the main criterion for selection
of healthcare institutions. The study included 994 randomly selected patients
treated surgically and conservatively in 2012. Results. Average costs under
the current payment method were slightly higher than those projected by DRG,
however, the variability was twice as high (54,111 ± 69,789 compared to
53,434 ± 32,509, p < 0,001) respectively. The univariate analysis showed that
the highest correlation with the current payment method as well as with the
projected one by DRG was observed in relation to the number of days of
hospitalization (ρ = 0.842, p < 0.001, and ρ = 0.637, p < 0.001,
respectively). Multivariate regression models confirmed the influence of the
number of hospitalization days to costs under the current payment system (β =
0.843, p < 0.001) as well as under the projected DRG payment system (β =
0.737, p < 0.001). The same predictor was crucial for the difference in the
current payment method and the projected DRG payment methods (β = 0.501, p
<0.001). Conclusion. Payment under the DRG system is administratively more
complex because it requires detailed and standardized coding of diagnoses and
procedures, as well as the information on the average consumption of
resources (costs) per DRG. Given that aggregate costs of treatment under two
hospital payment methods compared in the study are not significantly
different, the focus on minor surgeries both under the current hospital
payment method and under the introduced DRG system would be far more
cost-effective for a hospital as great variations in treatment performance
(reduction of days of hospitalization and complications), and consequently
invoiced amounts would be reduced.
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