Efficiency in Hospital Expenditure: A Study of the Diagnosis System Related Groups (DRG)

Abstract

The Diagnosis Related Groups (DRG) is a hospital classification system and has been used by several countries as the main method for prospective payment to hospitals. It is an important way of remuneration in the supplementary health sector. The DRG aims to support cost management, to improve the efficiency of the hospital expenses and to reduce the hospitalization time of the patients. This research aims to do a systematic review of Diagnosis Related Groups, based on articles from international journals that used regression models. Data were analyzed with descriptive statistics and interpretative analysis. The results show that the developed countries have the domain of academic production in this subject. However, there is still a lot of space for refinements and new research, as well as DRG adaptations for developing countries. The results indicate also that DRG has already been successfully implanted in several countries, and its application in Brazilian hospitals is suggested. This research makes it possible to show that Hospitals can have greater control over the costs with DRG, in order to stablish a model of payment by classifications and groups. This is based on the basic rate multiplied by a specific weight relative to each DRG. Therefore, the results of this research point a positive effect to explain the length of stay in hospitals and changes in costs.