Mehmood A, Ahmed Z, Ghilan K, Damad A, Azeez FK. Inpatient Case-mix Cost Vs Average Cost for Health Care Services in King Fahd Central Hospital, Saudi Arabia: A Comparative Study.
INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2021;
58:469580211056060. [PMID:
34796754 PMCID:
PMC8607483 DOI:
10.1177/00469580211056060]
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Abstract
Health care systems aim to deliver high-quality medical care while considering
efficient resource usage and cost-effective forms of interventions. Such
purposes require scientific tools or mechanisms which aid in cost assessment
before the efforts of cost reduction are considered. Diagnosis-related groups
based costing methodology (Case-mix) is considered one of the preferred costing
approaches in the health care sector. King Fahd Central hospital Jazan, the only
tertiary hospital in the Jazan region, was selected for case-mix system-based
patient-level costing of health services. The study’s objective was to estimate
the cost per Diagnosis-Related Group (DRG) per inpatient admission and compare
it with the already established average cost of health care services for
inpatients. We applied a cross-sectional retrospective approach to categorize
the inpatients based on their diagnosis and procedures and then estimate the
actual cost of health care services provided to inpatients during 2018 and
compared it with the average cost of the health services. There was a
considerable difference between DRG-based costing (SAR 269,663,897) and average
costing (SAR 247,035,938). The Diagnosis Related Group costing was found to be
more reliable and representative of the services provided to the patients and is
recommended to be used for reimbursement purposes.
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