Department of Public and Social Policy, Institute of Sociological Studies, Faculty of Social Sciences, Charles University, Pekařská 16, 158 00 Praha 5, Czech Republic.
Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, nám. Sítná 3105, 272 01 Kladno 2, Czech Republic.
Int J Environ Res Public Health. 2021 May 20;18(10):5463. doi: 10.3390/ijerph18105463.
(1) Background: Diagnosis-Related Groups (DRG), one possibility of a hospital payment system, are currently used in most European countries. Introduced to the Czech system in the 1990s, the DRGs are currently used mainly for care reporting and partly for reimbursement. According to most experts, the use of DRG remain controversial. The goal of this paper was to study the effects of the current Czech DRG system on hospitals financing and, on this basis, to propose possible changes to the reimbursement mechanism in the Czech Republic. (2) Methods: Qualitative research methods were used for evaluating DRG mechanisms of application in three selected healthcare establishments in the CR in the period of 2012-2018. (3) Results: Our study shows that the current implementation of the DRG system is set up in a way that is very similar to traditional flat rates and is unlikely to yield major positive effects of the DRG mechanism, such as predictability of payments for hospitalisation cases, care quality and efficiency and transparent financing. (4) Conclusions: Based on our results, deep systemic change of the reimbursement mechanism in the Czech Republic is necessary. We propose five partial measures leading to the cultivation of the Czech DRG.
(1) 背景：诊断相关分组（DRG）是一种可能的医院支付系统，目前在大多数欧洲国家使用。20 世纪 90 年代引入捷克系统，DRG 目前主要用于护理报告，部分用于报销。根据大多数专家的说法，DRG 的使用仍然存在争议。本文的目的是研究当前捷克 DRG 系统对医院融资的影响，并在此基础上提出对捷克共和国报销机制的可能改革。
(2) 方法：在 2012-2018 年期间，使用定性研究方法评估了捷克共和国三家选定医疗机构中 DRG 应用机制。
(3) 结果：我们的研究表明，当前的 DRG 系统实施方式与传统的统一定额非常相似，不太可能产生 DRG 机制的主要积极影响，例如对住院病例支付的可预测性、护理质量和效率以及透明的融资。
(4) 结论：基于我们的结果，有必要对捷克共和国的报销机制进行深入的系统改革。我们提出了五项局部措施，以培育捷克的 DRG。
