Impact of Hospital Provider Payment Reforms in Croatia

Bogut, Martina; Vončina, Luka; Yeh, Ethan

doi:10.1596/1813-9450-5992

Cited by 6 publications

(5 citation statements)

References 9 publications

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“…5 The introduction of a DRG-based system in Croatia also reduced the average length of stay but had little impact on volume and no adverse effect on quality. 12 MorenoSerra and Wagstaff 90 have assessed the shift from input-based budgeting to case-based payment methods in several countries of eastern and central Europe and central Asia. Although they assessed all case-based payment systems and not just those based on DRGs, overall they found a decrease in average length of stay and no increase in hospital admissions, but there was an increase in inpatient expenditure per case.…”

Section: Discussionmentioning

confidence: 99%

Hospital payment systems based on diagnosis-related groups: experiences in low- and middle-income countries

Mathauer

Wittenbecher²

2013

Bull. World Health Organ.

168

159

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Section: Discussionmentioning

confidence: 99%

Hospital payment systems based on diagnosis-related groups: experiences in low- and middle-income countries

Mathauer

Wittenbecher²

2013

Bull. World Health Organ.

168

159

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“…This is due to the fact that contributions are paid fully by employers. According to a 2012 study (Bogut, Vončina and Yeh, 2012), both broad-based and comprehensive case-based payment systems have improved efficiency as measured by a reduction in average length of stay, with little impact on the number of cases treated and no adverse impact on quality as measured by readmissions.…”

Section: Population Ageing Poses Another Challengementioning

confidence: 99%

Croatia: Country Health Profile 2017

2017

State of Health in the EU

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HighlightsDespite a challenging economic context and major fiscal pressures on health expenditure, Croatia has managed to keep publicly funded health services accessible to its population. The country has undertaken a number of important health reforms in recent years to improve health system performance, but the reforms have not been systematic and some have been abandoned. EffectivenessThere are high rates of amenable mortality but Croatia does better than other countries with the same level of health expenditure. AccessSelf-reported access to health care in Croatia is good, with low numbers reporting unmet needs for medical care, but there is substantial variation between income groups.

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“…Although it is early to precisely determine the impact of introduction of formal diagnostic-related groups in Croatia, it seems that case-based system of payment has improved efficiency in acute hospital care. 37 …”

Section: Diagnosis-related Group-based Financing Of Hospital Care: a mentioning

confidence: 99%

Review of Diagnosis-Related Group-Based Financing of Hospital Care

Mihailović

Kocić

Jakovljević

2016

Health Services Research and Managerial Epidemiology

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Since the 1990s, diagnosis-related group (DRG)-based payment systems were gradually introduced in many countries. The main design characteristics of a DRG-based payment system are an exhaustive patient case classification system (ie, the system of diagnosis-related groupings) and the payment formula, which is based on the base rate multiplied by a relative cost weight specific for each DRG. Cases within the same DRG code group are expected to undergo similar clinical evolution. Consecutively, they should incur the costs of diagnostics and treatment within a predefined scale. Such predictability was proven in a number of cost-of-illness studies conducted on major prosperity diseases alongside clinical trials on efficiency. This was the case with risky pregnancies, chronic obstructive pulmonary disease, diabetes, depression, alcohol addiction, hepatitis, and cancer. This article presents experience of introduced DRG-based payments in countries of western and eastern Europe, Scandinavia, United States, Canada, and Australia. This article presents the results of few selected reviews and systematic reviews of the following evidence: published reports on health system reforms by World Health Organization, World Bank, Organization for Economic Co-operation and Development, Canadian Institute for Health Information, Canadian Health Services Research Foundation, and Centre for Health Economics University of York. Diverse payment systems have different strengths and weaknesses in relation to the various objectives. The advantages of the DRG payment system are reflected in the increased efficiency and transparency and reduced average length of stay. The disadvantage of DRG is creating financial incentives toward earlier hospital discharges. Occasionally, such polices are not in full accordance with the clinical benefit priorities.

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Impact of Hospital Provider Payment Reforms in Croatia

Cited by 6 publications

References 9 publications

Hospital payment systems based on diagnosis-related groups: experiences in low- and middle-income countries

Hospital payment systems based on diagnosis-related groups: experiences in low- and middle-income countries

Croatia: Country Health Profile 2017

Review of Diagnosis-Related Group-Based Financing of Hospital Care

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