J Korean Med Assoc.  2020 Aug;63(8):493-503. 10.5124/jkma.2020.63.8.493.

Effects of the new diagnosis-related group-based payment system and the increased incentive policy rates on the utilization rate of diagnostic laboratory test in Korea

Affiliations
  • 1Department of Laboratory Medicine, National Medical Center, Seoul, Korea
  • 2Department of Laboratory Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
  • 3Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
  • 4Department of Neurology, Seoul Medical Center, Seoul, Korea
  • 5Department of Preventive Medicine, Konkuk University School of Medicine, Seoul, Korea
  • 6Department of Laboratory Medicine, Chungnam National University School of Medicine, Daejeon, Korea

Abstract

A new diagnosis-related group (DRG) based payment system has been implemented in most public hospitals in Korea. We investigated the effects of the new DRG system and its incentive policy on the utilization rate of diagnostic laboratory tests. Three groups were categorized; 36 hospitals under the new DRG system (participant group), 72 hospitals (control-1) matching with 36 participants according to the number of beds, and 42 tertiary hospitals (control-2). The patients of acute myocardial infarction, cerebral infarction, type 2 diabetes mellitus, and gonarthrosis receiving total arthroplasty were included. We analyzed the mean length of stay and the number of diagnostic laboratory tests conducted during hospitalization of the three groups according to the new DRG system and the incentive policy rates under the new DRG system. Before participating in the new DRG system, the number of diagnostic laboratory tests in the participant group was less than that in the two control groups for all four diseases. However, although the participant group’s length of stay decreased under the new DRG system, the number of diagnostic laboratory tests increased as the maximum incentive policy rate increased. The increment of the number of diagnostic laboratory tests was prominent in the period of a maximum of 35% incentive policy rates. Finally, the number of diagnostic laboratory tests of the participant group was similar to or exceeded that of the control-2 group. The new DRG system’s incentive policy rates played a driving force on the increased utilization rate of the diagnostic laboratory test. For preparing in advance for the change in incentive policy rates, monitoring and guidelines for the utilization of diagnostic laboratory tests are necessary.

Keyword

New diagnosis-related groups; Incentive policy; Diagnostic laboratory tests
Full Text Links
  • JKMA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2020 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr