engleski

Investigation of the Reimbursement Scheme in Croatian Public Hospitals: a Data Envelopment Analysis Approach

Hospitals in Croatia are burdened with insufficient inflow of financial resources which has a negative influence on hospital solvency and financial results. In order to equalize hospital cost structure and stimulate hospital performance and quality at the same time, the Croatian Government introduced in 2006 the diagnosis- related groups payment scheme called DRG methodology. DRG is a system for classification of acute hospital inpatient treatments which enables standardization of hospital procedures, controlling costs, measuring efficiency, and quality in secondary and tertiary (hospital) health care. If hospitals improve their efficiency, an improvement in the efficiency of the health care system may also be expected. The purpose of this paper is to evaluate relative efficiency of public hospitals in Croatia based on DRG procedure K60B - diabetes without very severe and severe comorbidity and complications. The hospital level data were analysed using Data Envelopment Analysis which indicated that Croatian hospitals, regarding DRG K60B, operate at a similar efficiency level. This leads to the conclusion that introduction of the DRG payment system in Croatian hospitals has justified its purpose, at least within the observed DRGs. If we cumulatively observe the sources and the amounts of relative inefficiency, days of lying should be reduced the most - on average by 16.71%. The research results may serve to health policy makers as guidelines for more efficient use of health resources as this paper provides theoretical and practical contribution to the evaluation of relative hospital efficiency regarding the DRG reimbursement scheme.

Diagnosis Related Groups, Data Envelopment Analysis, hospitals, indebtedness, reimbursement scheme

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