J Korean Med Assoc.  2012 Aug;55(8):706-709. 10.5124/jkma.2012.55.8.706.

Perspectives on cost containment and quality of health care in the DRG payment system of Korea

Affiliations
  • 1Graduate School of Public Health, Korea University, Seoul, Korea. shine@korea.ac.kr
  • 2Institute for Environmental Health, Korea University, Seoul, Korea.

Abstract

The Korean medical community has recently faced political conflicts with the government in the implementation of the Korean diagnosis-related groups (DRG) payment system. This study found that scientific evidence is insufficient so far to support the claim that the DRG results in lower medical expenses without sacrificingthe quality of health care. There is no 'free lunch' and 'free DRG' as well. Unreasonable and compulsory implementation of the Korean DRG may give rise to an unwanted burden to both the Korean people and medical community. The economic burden of the patient is unlikely to decrease after Korean DRG application, given the lack of scientific and political evidence for this possibility. We can expect that the systems will be effective in holding down medical expenses in the long term. However, it will not be practical without the reduction of medical expenses by means such as reducing hospitalization service and other medical service amount. The enforcement of the Korean DRG payment system appears to be one of the typical cases of excessive state intervention in health policy in the history of Korea.

Keyword

Diagnosis-related groups; Quality of health care; Cost containment; Korea

MeSH Terms

Cost Control
Diagnosis-Related Groups
Health Policy
Hospitalization
Humans
Korea
Quality of Health Care

Cited by  2 articles

The Effect of Diagnosis-Related Group Payment System on Quality of Care in the Field of Obstetrics and Gynecology among Korean Tertiary Hospitals
Yong Wook Jung, Haeyong Pak, Inha Lee, Eui Hyeok Kim
Yonsei Med J. 2018;59(4):539-545.    doi: 10.3349/ymj.2018.59.4.539.

Securing patient access to new medical technology under the diagnosis-related group system in South Korea: a review of foreign policies and selective reimbursement coverage programs for 4 major conditions
Hyojung Hwang, Sang-Soo Lee, San-Hui Lee
J Korean Med Assoc. 2017;60(1):63-71.    doi: 10.5124/jkma.2017.60.1.63.


Reference

1. Ministry of Health and Welfare. DRG: misunderstanding and truth. 2012. Seoul: Ministry of Health and Welfare.
2. Ministry of Health and Welfare. 2011. cited 2012 Jul 16. Available from: http://m.mw.go.kr/data/bodo_view.jsp?MENU_ID=0403&cont_seq=254176&page=4.
3. Eggers PW. Prospective payment system and quality: early results and research strategy. Health Care Financ Rev. 1987. Spec No:29–37.
4. Sager MA, Easterling DV, Kindig DA, Anderson OW. Changes in the location of death after passage of Medicare's prospective payment system: a national study. N Engl J Med. 1989. 320:433–439.
Article
5. Sager MA, Leventhal EA, Easterling DV. The impact of Medicare's prospective payment system on Wisconsin nursing homes. JAMA. 1987. 257:1762–1766.
Article
6. Leibson CL, Naessens JM, Campion ME, Krishan I, Ballard DJ. Trends in elderly hospitalization and readmission rates for a geographically defined population: pre- and post-prospective payment. J Am Geriatr Soc. 1991. 39:895–904.
Article
7. Schwartz WB, Mendelson DN. Hospital cost containment in the 1980s. Hard lessons learned and prospects for the 1990s. N Engl J Med. 1991. 324:1037–1042.
8. Brizioli E, Fraticelli A, Marcobelli A, Paciaroni E. Hospital payment system based on diagnosis related groups in Italy: early effects on elderly patients with heart failure. Arch Gerontol Geriatr. 1996. 23:347–355.
Article
9. Louis DZ, Yuen EJ, Braga M, Cicchetti A, Rabinowitz C, Laine C, Gonnella JS. Impact of a DRG-based hospital financing system on quality and outcomes of care in Italy. Health Serv Res. 1999. 34(1 Pt 2):405–415.
10. Forgione DA, Vermeer TE, Surysekar K, Wrieden JA, Plante CA. The impact of DRG-based payment systems on quality of health care in OECD countries. J Health Care Finance. 2004. 31:41–54.
11. Theurl E, Winner H. The impact of hospital financing on the length of stay: evidence from Austria. Health Policy. 2007. 82:375–389.
Article
12. Busato A, von Below G. The implementation of DRG-based hospital reimbursement in Switzerland: a population-based perspective. Health Res Policy Syst. 2010. 8:31.
Article
13. Fuerstenberg T, Laschat M, Zich K, Klein S, Gierling P, Nolting H-D, Schmidt T. G-DRG-supporting research in accordance with § 17b para 8 KHG.German hospital Verlagsgesellschaft mbH. 2011. 471–544.
14. Hamada H, Sekimoto M, Imanaka Y. Effects of the per diem prospective payment system with DRG-like grouping system (DPC/PDPS) on resource usage and healthcare quality in Japan. Health Policy. 2012. 01. 23. [Epub]. DOI: http://dx.doi.org/10.1016/j.healthpol.2012.01.002.
Article
15. Kang MS, Chung YK, Yeoum SG, Baik KA. Comparative analysis of diagnosis-related-groups payment and fee service. Chung-Ang J Nurs. 2001. 5:35–41.
16. Shon C, Chung S, Yi S, Kwon S. Impact of DRG payment on the length of stay and the number of outpatient visits after dis-charge for caesarean section during 2004-2007. J Prev Med Public Health. 2011. 44:48–55.
Article
17. Department of Health Policy and Management. Seoul National University College of Medicine, Korea Health Industry Development Institute. Evaluation seminar of the DRG demonstration project. 2000. cited 2012 Jul 18. Seoul: Available from: www.cykim.pe.kr/DRGSem.PDF.
Full Text Links
  • JKMA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr