Impacts of Payment Modes for Chronic Diseases by Diagnosis-Related Groups (Drgs) on Preventive Incentives of Medical Association

Abstract

To analyze prevention and treatment efforts under payment by DRGs, the optimal decision models of each participant are established. Prevention efforts of the community hospital and treatment efforts of the tertiary hospital under different payment modes have to be compared with the centralized decision-making of medical association. The results show some underpayment in both community and tertiary hospitals when the fees are charged according to the types of patients and the utility of the community hospital account in proportion to the total utility of the patients is a suitable value at the stage of treatment. Through DRGs, optimal prevention and treatment efforts under the centralized decision-making of medical association, and the maximization of social total utility are achieved.