TITLE:
Medical Stakeholders’ Views on the Use of Packaged Charging Based on the Diagnosis-Related Group (DRG) in the Proposed Healthcare Reform
AUTHORS:
Fiona Y. Y. Wong, Frank W. K. Chan, Su Liu
KEYWORDS:
Diagnosis-Related Group; Hospital Charges; Prospective Payment; Healthcare Reform
JOURNAL NAME:
Journal of Service Science and Management,
Vol.6 No.5,
December
27,
2013
ABSTRACT: The second stage consultation of
healthcare reform in Hong Kong was launched in late 2010. One of the key features
in the healthcare reform is the use of packaged charging based on
Diagnosis-Related Group (DRG) structure, for reimbursement of medical fees in
order to enhance cost certainty and transparency in private healthcare
services. The objective of the study was to investigate the comments, concerns
and suggestions of medical practitioners and private hospitals about medical
pricing based on DRG. A survey completed by 1100 medical practitioners, seven focus groups with 42 medical
practitioners and six hospital administrators participated was conducted. Generally, the
participants believed that DRG was more applicable to straight-forward and
one-off treatment procedures. Those working in the private sector and
non-Family Medicine specialists were more concerned about the desirability and
feasibility of DRG, and the potential of control of pricing in private market. The
practice of DRG-based pricing method in certain specialties and cases which
required multiple examinations and procedures for diagnosis were discussed.
Concerns about doctors’ selection of cases, upcoding and
gaming on the charging system, as well as the high administration cost were
also raised.