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Analysis of Drug Utilization after the Mandatory Application of the DRG Payment System in Korea  

Kang, Hee-Jeong (Health Insurance Review and Assessment Service)
Kim, Ji Man (Health Insurance Review and Assessment Service)
Lim, Jae-Young (Department of Food and Resource Economics, Korea University)
Lee, Sang Gyu (Graduate School of Public Health, Yonsei University)
Shin, Euichul (Graduate School of Public Health, The Catholic University)
Publication Information
Korea Journal of Hospital Management / v.23, no.2, 2018 , pp. 18-27 More about this Journal
Abstract
Purposes: This study aims to investigate the policy effect of mandatory application of DRG for 7 disease groups in general and tertiary hospitals. Methodology: As DRG was fully implemented in July 2013, this study compares two periods before and after the change(from July 2012 to June 2013, and from July 2013 to June 2014). The benefit claim data of the National Health Insurance Service was used for the comparison. Target patients were those who visited general or tertiary hospitals between July 2012 to June 2014. For pharmaceutical consumption, Interrupted Time Series (ITS) analysis was used to see the effect of DRG mandatory application. Findings: The number of drugs prescribed per patient and pharmaceutical expenditure both showed significant reduction compared to before the DRG implementation. Practical Implications: This study used 2 sets of 1 year period data from before and after the full implementation of DRG to analyze pharmaceutical consumption. When the comparison data accumulates further, it would be possible to conduct more diverse analysis to assess policy effect and to provide way forward for the future.
Keywords
DRG; severity level; interrupted time series;
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