PMID- 29754969
OWN - NLM
STAT- MEDLINE
DCOM- 20181126
LR  - 20220129
IS  - 1872-6054 (Electronic)
IS  - 0168-8510 (Linking)
VI  - 122
IP  - 7
DP  - 2018 Jul
TI  - Pathways to DRG-based hospital payment systems in Japan, Korea, and Thailand.
PG  - 707-713
LID - S0168-8510(18)30129-5 [pii]
LID - 10.1016/j.healthpol.2018.04.013 [doi]
AB  - Countries in Asia are working towards achieving universal health coverage while 
      ensuring improved quality of care. One element is controlling hospital costs 
      through payment reforms. In this paper we review experiences in using Diagnosis 
      Related Groups (DRG) based hospital payments in three Asian countries and ask if 
      there is an "Asian way to DRGs". We focus first on technical issues and follow 
      with a discussion of implementation challenges and policy questions. We reviewed 
      the literature and worked as an expert team to investigate existing documentation 
      from Japan, Republic of Korea, and Thailand. We reviewed the design of case-based 
      payment systems, their experience with implementation, evidence about impact on 
      service delivery, and lessons drawn for the Asian region. We found that countries 
      must first establish adequate infrastructure, human resource capacity and 
      information management systems. Capping of volumes and prices is sometimes 
      essential along with a high degree of hospital autonomy. Rather than introduce a 
      complete classification system in one stroke, these countries have phased in 
      DRGs, in some cases with hospitals volunteering to participate as a first step 
      (Korea), and in others using a blend of different units for hospital payment, 
      including length of stay, and fee-for-service (Japan). Case-based payment systems 
      are not a panacea. Their value is dependent on their design and implementation 
      and the capacity of the health system.
CI  - Copyright (c) 2018 Elsevier B.V. All rights reserved.
FAU - Annear, Peter Leslie
AU  - Annear PL
AD  - Nossal Institute for Global Health, School of Population and Global Health, 
      University of Melbourne, Australia.
FAU - Kwon, Soonman
AU  - Kwon S
AD  - School of Public Health, Seoul National University, Republic of Korea. Electronic 
      address: kwons@snu.ac.kr.
FAU - Lorenzoni, Luca
AU  - Lorenzoni L
AD  - OECD, Paris, France.
FAU - Duckett, Stephen
AU  - Duckett S
AD  - The Grattan Institute, University of Melbourne, Australia.
FAU - Huntington, Dale
AU  - Huntington D
AD  - Johnson and Johnson, Singapore.
FAU - Langenbrunner, John C
AU  - Langenbrunner JC
AD  - Consultant, USA.
FAU - Murakami, Yuki
AU  - Murakami Y
AD  - OECD, Paris, France.
FAU - Shon, Changwoo
AU  - Shon C
AD  - School of Public Health, Seoul National University, Republic of Korea.
FAU - Xu, Ke
AU  - Xu K
AD  - World Health Organization, Geneva, Switzerland.
LA  - eng
GR  - 001/WHO_/World Health Organization/International
PT  - Journal Article
DEP - 20180507
PL  - Ireland
TA  - Health Policy
JT  - Health policy (Amsterdam, Netherlands)
JID - 8409431
MH  - Diagnosis-Related Groups/*economics
MH  - Fee-for-Service Plans
MH  - *Hospital Costs
MH  - Humans
MH  - Japan
MH  - Length of Stay/economics
MH  - Republic of Korea
MH  - Thailand
OTO - NOTNLM
OT  - Case-based payment
OT  - DRG
OT  - Diagnosis-related groups
OT  - Hospital payment system
EDAT- 2018/05/15 06:00
MHDA- 2018/11/27 06:00
CRDT- 2018/05/15 06:00
PHST- 2016/10/27 00:00 [received]
PHST- 2018/03/21 00:00 [revised]
PHST- 2018/04/30 00:00 [accepted]
PHST- 2018/05/15 06:00 [pubmed]
PHST- 2018/11/27 06:00 [medline]
PHST- 2018/05/15 06:00 [entrez]
AID - S0168-8510(18)30129-5 [pii]
AID - 10.1016/j.healthpol.2018.04.013 [doi]
PST - ppublish
SO  - Health Policy. 2018 Jul;122(7):707-713. doi: 10.1016/j.healthpol.2018.04.013. 
      Epub 2018 May 7.