AI Article Synopsis

  • The healthcare system in Malta offers free services at the point of use and is funded through global budgets, prompting an exploration of implementing a Diagnosis Related Groups (DRG) system to manage and measure resource use.
  • The study analyzed 151,615 hospital admissions from 2009 to 2011, identifying 636 DRG categories, with about half of them accounting for 99% of total hospital activity.
  • The findings indicate a low variability in patient treatment within the DRG groups, supporting the potential introduction of a DRG system in Malta, especially in light of evolving public-private partnerships and new legislation for cross-border patient care.

Article Abstract

The healthcare system in Malta is financed through global budgets and healthcare is provided free at the point of use. This paper is a first attempt to examine the feasibility of introducing a Diagnosis Related Groups casemix system for Malta, not necessarily for payment and funding purposes, but as a tool to help describe, manage and measure resource use. This is particularly challenging in view of the constraints and characteristics of a small state country. The study evaluates the applicability of the MS-DRG (Version 27.0) Grouper to describe acute hospital activity on the island. The classification of 151,615 admissions between 2009-2011 resulted in 636 DRG categories. Around half of these DRGs accounted for 99% of the total activity at the hospital, while 296 DRG categories had fewer than 15 cases over the period. Patient length of stay is used to explain resource use and the Coefficient of Multiple Determination obtained was of 0.19 (improving to 0.25 when a number of trimming algorithms were applied). A good proportion of the resulting DRGs had a Coefficient of Variation, which indicates a low degree of variability within the obtained DRG groups. This presents good evidence to support the introduction of a DRG system in Malta particularly in view of the recent drive towards more public-private partnerships and legislation on cross-border patient treatment.

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http://dx.doi.org/10.1016/j.healthpol.2018.08.002DOI Listing

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