Ghaffari Sh¹ * (MD, PhD), Abolhallaj M² (MS), Pouragha B^1,3 (MS)

  ¹ Social Security Organization, Tehran, Iran

  ² Center of Budgeting and Performance Monitoring in Ministry of Health, Tehran, Iran

  ³ School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

  Received: 24 Aug 2011, Accepted: 13 Jul 2012

  Abstract

  Introduction: DRG is a patient classification system that classifies acute hospital inpatients based on their clinical similarity and resource homogeneity. The classification system was introduced in 1970s in the US, for performance measurement and quality assurance purpose however, it was mainly used as budgeting and reimbursement tool. The purpose of this study was to evaluate the feasibility of implementing the casemix and DRG in Iran.

  Methods: This study was conducted in two separate stages. First, we used a questionnaire to evaluate the knowledge and attitude of hospitals’ managers toward current budgeting system, DRG and casemix. Then, availability of patients’ demographic, clinical and financial information in selected hospitals was evaluated.

  Results: About 60% and 66% of the respondents believed that implementing case mix and DRGs were feasible in hospitals run by Ministry of Health, respectively. The positive attitude of participants was correlated with their level of education. Clinical and demographic information were collected in all hospitals. The accrual-based accounting system was only used in one of the studied hospitals.

  Conclusion: DRG, in Iran, can be implemented in a short- mid-term period. Although patients’ clinical and demographic information are available in Irans' hospitals, calculating the DRG cost weight requires converting a cash-based to accrual-based accounting system. Resistance to changes among the hospitals’ physicians and staff can be reduced through provision of appropriate information about applications of the DRG and its benefits.

  Key words: DRG, casemix, hospital, Iran