„Cu privire la mecanismele de finanţare a spitalelor: Caz tratat, buget global, CHM, PMSI, DRG” Conceptul DGO (DRG- oncologie)

Abstract

It would be optimal for the oncological system to exclude the patients with malignant tumors from the insurance system. Care for oncological patients with histologically confirmed diagnosis should be provided from the state budget. Criteria of grouping the diseases, currently proposed by the National Company of Insurance in Medicine, are not very appropriate for the oncological service, because they distort sometimes the oncological canons. deem it necessary to use the criteria based on national DRG system, only after introducing a new compartment for benign tumors, called “DRG - Oncology” (DGO). The diagnosis groups (1 - skin, 2 - soft tissues, 3 - bones, etc.) and tumors should be grouped with TDR index, where T stands for groups of benign tumors of an organ, D-elements of diagnosis and treatment, R-level of medical risks. Remunerations based on DRG seems to have a proper perspective for the Republic of Moldova, although it is very expensive. The development of a national version of DRG is a very difficult and painstaking job, requiring special-purpose state subsidies for the implementation of computer technologies, able to calculate the cost of medical services based on DRG. It should be noted that the practical implementation of these technologies will contribute to a faster transition of the national health care system to the medical insurance system. Financing mechanisms of DRG social disease hospitals should be argumented, otherwise, they can lead to bankrupsy. It is necessary to determine the specific costs for diagnosis and treatment malignant and benign tumors, in outpatient and inpatient.