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Main Changes in the Model of Diagnosis-Related Groups in Russia in 2020

Issue № 1 | 2020 (39)

DOI: https://doi.org/10.31556/2219-0678.2020.39.1.019-029 meta

Abstract

Since 2013 a diagnosis-related groups (DRG) model has been introduced for the payment of medical care provided in inpatient settings and the day hospitals in Russia at the federal level. The DRG model is improved annually by the increasing of DRG number and specifying the classification criteria for attributing treatment cases to a particular group. In this article, we describe the main changes in the DRG model in 2020 compared with the last year. Main changes include the creation of new classification criteria for the formation of DRG, new DRG in the oncology profile, the changes in the DRG for epilepsy and chronic viral hepatitis C treatment, as well as for the use of genetically engineered biological drugs and selective immunosuppressants. The article also describes the innovations regarding the general approaches to paying for health care with respect to DRG: the rules for applying regional correction factors and for simultaneous payment for two DRG within one treatment case.

Keywords

provider-payment method in healthcare, diagnosis-related groups (DRG), classification criteria.

For citation

Lazareva M.L., Zheleznyakova I.A., Avxentyeva M.V., Fedyaev D.V., Zuev A.V., Ledovskikh Y.A., Semakova E.V., Omelyanovskiy V.V. Main Changes in the Model of Diagnosis-Related Groups in Russia in 2020. Medical Technologies Assessment and Choice. 2020; (1):19–29. DOI: 10.31556/2219-0678.2020.39.1.019-029

mt_39_2020-1_19-29