Author(s)

Yangyue Hu ¹, Ran An ¹

Affiliation(s)

¹ Guangdong Medical University, dongguan, Guangdong, China

Corresponding Author

Yangyue Hu

ABSTRACT

The reform of DRGs in health insurance, as a major innovation in the current health insurance payment system, aims to optimize the allocation of resources, control the growth of medical costs and improve the quality of medical services. By introducing Disease Diagnosis Related Groups (DRGs) as the payment standard for medical services, the reform encourages medical institutions to improve efficiency and reduce unnecessary medical services, thus realizing reasonable control of medical costs. The core concept of the Medicare DRGs reform is to motivate healthcare providers to focus on service efficiency and quality through a fixed payment system. This reform not only changes the traditional fee-for-service model, but also encourages hospitals to improve the overall efficiency of medical services. In China, the implementation of this reform has shown that public healthcare organizations need to adapt to the new payment method and adjust their internal management and service model to meet the challenges and opportunities from the reform. The purpose of this paper is to explore the impact of the health insurance DRGs reform on the economic operation of public healthcare organizations, including the revenue structure, cost control, service quality, and management model.

KEYWORDS

Medicare DRGs reform; public healthcare organizations; economic operations

CITE THIS PAPER

Yangyue Hu, Ran An, Impact of Medicare DRGs Reform on the Economic Operation of Public Healthcare Organizations. Social Security and Administration Management (2024) Vol. 5: 1-8. DOI: http://dx.doi.org/10.23977/socsam.2024.050201.

REFERENCES

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[2] Laurence G, Anne L I V, Geneviève M, et al. Integrating Sustainable Diets in Healthcare Organizations: A Qualitative Study Among Key Informants about Challenges and Promising Avenues [J].Journal of Hunger Environmental Nutrition, 2024, 19(2): 311-312.
[3] Zhang Z, Mi J, Gu L, et al. Using sound Clinical Paths and Diagnosis-related Groups (DRGs)-based payment reform to bring benefits to patient care: A case study of leukemia therapy [J].Frontiers of Medicine in China, 2010, 4(1):8-15. 

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