DRG -based payment system, the hospital managers? approaches to this system

Although hospitals are categorized in service-oriented business domain, there are remarkable differences between them and other service-oriented business sectors. These differences usually lead to a lot of management difficulties in medical institutions where some challenging factors exist such as the need for various equipments or the coordination between different medical specialists. The liabilities in generating incomes and the limits in making decisions for the determination of resources during patients? medical treatments make it a more arduous and difficult task for executives in hospitals.Identification, categorization of hospitals and monitoring of the hospitals within these categories have been studied intensely both in Turkey and throughout the world. In addition, some recent studies in Turkey are being conducted for the categorization of hospitals on a legal basis. It is known that by the aid of such a categorization system, the hospitals could be reviewed, monitored, compared and evaluated.Clinical diagnoses have become a very important factor in medical refund system in which they can be used as active assets. The clinical diagnoses could be established in a standardized format. This could enable us to monitor whether the services provided to patients are compatible with the patients? requirements or not. This could also assist the estimation and determination of necessary financial resources. Eventually, the hospital management and physicians would be requiring more records and evidences for accurate diagnoses. The estimation and administration of disease costs will become more crucial for medical institutions which could lead to more time and labor usage in order to improve the efficiency of limited resources.The data collected from general health insurance system could be used for estimating the demand for health resources allocated to health services all around the country and determining the total amount of resources. The use of DRG?s (Diagnostic Related Groups) for the determination of the type of health services and the total amount of resources is known to be a new concept in Turkey. Therefore, the doctors? diagnosis of their patients and their role in making the final decision for resource allocation and consumption plays a very important role in producing such data. In this study, the physicians? as a manager approaches to the payment system based on DRG have been analyzed in a public hospital.Keywords: DRG (Diagnostic Related Groups), Diagnosis, Hospital, Cost