The Correlation Analysis of Relative Values of DRGs and The National Public Health Service Tarrifs in Turkey

Yıl 2019, Cilt: 1 Sayı: 1, 25 - 45, 07.01.2019

İlker Köse B. Ozge Elmas

Öz

This study aims to analyze the correlation between the
prices of public payment model (SUT) based on fee for service in Turkey with
the DRGs which has being disseminated since 2009 in public hospitals in Turkey.

For this analysis, the inpatient patient data of
Istanbul Haydarpaşa Numune Training and Research Hospital for 2015 were taken
as basis and the 28,493 files that the hospital sent to Social Security
Institution (SSI) and provisioned via SUT and the accrued amounts were
obtained. Then the DRGs are obtained from the Ministry of Health's DRG
application for the same cases. DRGs with fewer than 3 files were excluded from
the calculation and 28,365 files were studied.

The correlation between the SUT prices of 28.365 files
and the DRG’s relative values of each file was calculated as 0.67 (medium
related). The correlation between the average SUT prices of the 403 DRG groups
corresponding to these files and the relative values ​​was calculated as 0.79
(high correlation). When we investigate this relation based on the major
diagnostic classification (MDC) of the DRGs, the relation between the file
prices and the DRG relative values ​​is calculated as very weak in 7 MDCs, weak
in 9 MDCs, medium in 5 MDCs, high in 1 MDC. The relationship between average
SUT prices of each DRG group and their relative values ​​are also calculated as
very weak in 1 MDC, weak in 4 MDCs, medium in 4 MDCs, high in 8 MDCs and very
high in 5 MDCs.

The result of this analysis shows us the public
healthcare service prices are medium and/or highly related with the relative
values of DRGs applied in Turkey. Moreover, there are some issues to study on
particularly DRGs of some MDCs which have weak and very weak relation with SUT
prices (or vice versa).

Anahtar Kelimeler

DRG, correlation analysis, healthcare tarrifs, SUT

Kaynakça

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