Modelling of Healthcare Expenditures on Management of Patients with Diabetes Mellitus for Reimbursement under Diagnosis-Related Groups

Abstract

To improve the management of patients with diabetes mellitus (DM), a change to the current system of reimbursement for completed case treatment of this group of patients, followed-up in the outpatient departments of the hospitals, based upon obligatory health insurance fund was introduced. A new Diagnosis-Related Group (DRG) «Follow-up of patients» was proposed and proved to be listed in the medical register. Calculations based on the model of a patient with DM, who needs to be followed up and potentially has been diagnosed with complications of the disease. The model includes a patient’s stay in an outpatient department of the hospital for three days to be diagnosed and treated.