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"Drgs came into being in desperation. Speaking of which, this is the optimal solution to the current medical insurance deficit. It does not need to consider the medical level or the differences in patients. Instead, it is grouped from management and the huge patient data of the entire country. It is much better than clinical pathways and single-patient payments."

Xu Qiu was silent.

The implementation of Drgs in Daxia is actually just touching the country to cross the river.

In the 1980s, the elderly and disability health insurance funds of the country were once on the verge of bankruptcy. In the previous seventeen years, the average annual growth rate of medical expenses in the country reached 17%, and the total scale soared from US$3.4 billion in the 1960s to US$37 billion in the early 1980s, which was more than ten times more.

The following year, the medicare hospital in Berry Country was unable to withstand the tight health insurance fund and the pressure of financial pressure, and launched the drgs-pps system, which was the predecessor of drgs.

In short, it is to pre-standard the expenses and report them to the US Medical Insurance Center after the patient is discharged from the hospital. The center will allocate funds according to the prescribed expenses - no matter how much the final treatment costs, the money given by the medical insurance center will not change.

In the drgs-pps system, hospitals can only make profits by saving costs. Medicare Hospital uses this to eliminate the serious illness of medical insurance and turn losses into profits by reducing the treatment costs of hospitalized patients. Not only does the cost control effect be immediate, but the hospital's income has also increased significantly.

For this reason, the drgs-pps system was passed the following year by the Berry National Government and became the basic payment system for elderly medical insurance across the United States. It then gradually developed into a more complete drgs. A few years later, it was successively introduced by Europe, Australia and some Asian countries.

Daxia's previous medical insurance was "cost by project".

This system is almost entirely for patients. As long as the examination, treatment, hospitalization, surgery, etc. are performed during the medical treatment, it can be reimbursed. The total amount of the accumulated total of all medical means is given, the medical insurance will be given according to the reimbursement ratio.

But soon there were drawbacks. With the fuel of "cost by project", more and more inspections were conducted, and the prescription of medication became more complicated, and the profits of hospitals rose.

During that period, every hospital was crazily accepting patients. Even if he had ordinary hypertension and had a series of reasonable but unnecessary examinations, he could still get hundreds or even thousands of yuan from the medical insurance side through him.

Various major surgeries are even more attractive. Every patient has a walking 10,000 yuan in cash...

The medical insurance fund that implemented the "fee by project" almost collapsed.

Later, the emergency adjustment was made to slightly stop the phenomenon of "large inspections and prescriptions".

Today's drgs are actually the common demand of patients, hospitals and medical insurance bureaus. Patients hope to do less examinations and prescribe less medicine to reduce their own expenses. The hospital is calculating about using pitiful medical insurance costs, for fear that the hospital will be responsible for its own expenses in the future; medical insurance is worried that it will go bankrupt...

In this case, it is extremely attractive to solve excessive medical treatment, stimulate hospitals to control costs, and thus reduce patients' medical expenses.

The key is to encourage medical institutions to adjust their diagnosis and treatment structures, reduce non-human costs, such as devices and drugs, and increase human remuneration.

However, its success depends on two foundations: high-quality clinical diagnosis and treatment capabilities, and extremely detailed funding data.
Chapter completed!