Lab Med Online.  2021 Jan;11(1):47-54. 10.47429/lmo.2021.11.1.47.

Physicians’ Understanding of the New Diagnosis-Related Group (NDRG) Payment System According to NDRG Participation

Affiliations
  • 1Department of Laboratory Medicine, Veterans Health Service (VHS) Medical Center, Seoul, Korea
  • 2Department of Social and Preventive Medicine, Health Services Research Center 2 , College of Medicine, Hallym University, Chuncheon, Korea
  • 3Department of Laboratory Medicine, Inje University, Ilsan Paik Hospital, Goyang, Korea
  • 4Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
  • 5Department of Neurology, Seoul Medical Center, Seoul, Korea
  • 6Department of Preventive Medicine, School of Medicine, Konkuk University, Seoul, Korea
  • 7Department of Laboratory Medicine, School of Medicine, Chungnam National University, Daejeon, Korea

Abstract

Background
The medical insurance payment system can have a considerable effect on quality of care, medical expenses, and laboratory test utilization. The new diagnosis-related group (NDRG) is a mixed payment system implemented throughout many hospitals. To date, physicians’ level of understanding of the NDRG system has received minimal research attention. We have conducted a survey targeting doctors affiliated with various hospitals.
Methods
Forty-two NDRG participating public hospitals (participant group), and 84 non-participating hospitals (non-participant group) were included in this study. Three physicians per hospital (clinical pathologist, internist, and surgical specialist) were asked to complete a questionnaire about the influence of the NDRG system. A total of 116 doctors (32.5%) responded.
Results
Recognition of the NDRG was significantly higher among the participant group than among non-participants (87.9% vs. 45.8%, P = 0.001). About half of the respondents expected introduction of the NDRG to help reduce medical overuse and length of stay, while about 80% expected a negative impact on overall quality of care and quality control for laboratory tests, irrespective of group. In terms of patient satisfaction and inpatient laboratory test utilization, the participant group responded more positively. About half of the respondents had some knowledge of quality incentives, and about 90% agreed with the need for additional rates or application of quality incentives under the NDRG system.
Conclusions
In this study, the physicians’ degree of understanding of the NDRG system was quantitatively assessed, and some areas in need of reform were addressed.

Keyword

New diagnosis-related group payment system; Physicians’ understanding; Laboratory test utilization.

Reference

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