The presentation of the book "Hospital Financing by Groups Diagnosis-Related Groups: World Experience and Recommendations for Georgia" by Tengiz Verulava and Revaz Zorbenadze took place on October 24.
The President of Caucasus University, Kakha Shengelia, addressed the audience at the presentation.
The project has won the publishing grant competition of the Shota Rustaveli National Science Foundation of Georgia (grant number SP-23-215).
The author spoke about the book at the event.
Since November 2022, Georgia has implemented a new hospital financing model under its universal healthcare program, recognized as one of the most equitable systems worldwide. This system, known as Diagnosis-Related Groups (DRG), represents a significant reform in hospital funding. Under the DRG model, hospital reimbursement is determined by the patient's diagnosis, using pre-assessed treatment standards as the basis for funding allocation.
With the transition to the DRG funding model, the payment system underwent a change. Previously, clinics set their own rates, and the state did not regulate the amount patients had to contribute, resulting in patients often paying much more in addition to the official co-payment of 30%, 20%, or 10%, at different medical organization. This system placed a heavy financial burden on patients and created transparency issues. It was difficult for the state to explain to patients the reasons behind the unpredictable increases in their co-payments.
After transitioning to the DRG financing model, clinics are no longer permitted to request additional payments from patients beyond the official co-payment. The system assigns a fixed tariff for each diagnosis, and the patient's co-payment is set within the range of 0 to 30%, as determined by the state for various population groups.
Based on the above, the use of the financing method with DRG contributes to the financial availability of healthcare services, transparency, and quality improvement, which has a positive impact on the satisfaction of the population.
Institute of Health Policy, Caucasus University.
