A study of medical treatment practices of vaginal delivery before and after application of DRGs payment system.
This study was designed to analyze factors, medical service practices and medical fee differences which influence the amount of medical services and medical fees when applying a Fee For Service system rather than a Diagnosis Related Group payment system.
The subjects were 178 patients who were hospitalized and underwent vaginal delivery. Half (89) fell under DRG, and the other half (89) fell under FFS. By using all the data, including medical treatment fee statements, bills, and patient medical charts, we obtained the following results:
First, there was a big gap between the DRG patients and the FFS patients.
Second, medical treatment revenues increased when FFS was applied compared to DRG.
Third, there was an increase in patients medical fees, including the fees that were not covered by medical insurance, when DRG was applied.
Fourth, there was a decrease in patients medical fees that were not covered when DRG was applied.
In conclusion, when FFS was applied to the patients who underwent vaginal delivery without complications, the number of hospitalization days, medical fees, and patients medical co-payments, including fees not covered by medical insurance, had increased, which led to an increase in hospitals revenues.
From now on, there should be more studies on changes in the seven objects which were applied to DRG and all the hospitals which were applied to DRGs payment system. In addition, individual patient characteristics (such as occupation, educational level, and financial situation) and doctor's diagnosis types should also be considered. Finally, diverse approaches should be undertaken to improve patient care quality, enhance hospital medical revenues and reduce medical treatment costs.
