New approaches to formation of diagnosis-related groups for payment for radiotherapy and chemoradiotherapy based on clinical guidelines with the use of standardized modules of healthcare

The article presents a methodology and results of developing diagnosis related groups (DRGs) for the cases of healthcare provided with the use of radiotherapy and chemoradiotherapy for malignant neoplasms in Russian Federation. A key element of the methodology is the standardized module of healthcar...

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Main Authors: Yu. A. Ledovskikh, E. V. Semakova, V. V. Omelyanovskiy, A. A. Kravtsov, E. A. Prokhorovich, M. V. Avxentyeva, I. A. Zheleznyakova, A. V. Petrovskiy
Format: Article
Language:Russian
Published: Non-profit partnership for development of domestic photodynamic therapy and photodiagnosis "Russian Photodynamic Association" 2020-02-01
Series:Biomedical Photonics
Subjects:
Online Access:https://www.pdt-journal.com/jour/article/view/388
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author Yu. A. Ledovskikh
E. V. Semakova
V. V. Omelyanovskiy
A. A. Kravtsov
E. A. Prokhorovich
M. V. Avxentyeva
I. A. Zheleznyakova
A. V. Petrovskiy
author_facet Yu. A. Ledovskikh
E. V. Semakova
V. V. Omelyanovskiy
A. A. Kravtsov
E. A. Prokhorovich
M. V. Avxentyeva
I. A. Zheleznyakova
A. V. Petrovskiy
author_sort Yu. A. Ledovskikh
collection DOAJ
description The article presents a methodology and results of developing diagnosis related groups (DRGs) for the cases of healthcare provided with the use of radiotherapy and chemoradiotherapy for malignant neoplasms in Russian Federation. A key element of the methodology is the standardized module of healthcare (SM) which allows calculating the tariffs for medical care in accordance with clinical guidelines. As a result of the application of the new methodology, in 2019, changes were made to the DRG model in terms of payment for radiotherapy and chemoradiotherapy. The changes included developing 10 DRGs for in-patient radiotherapy and 10 DRGs in day hospital; 7 DRGs for in-patient chemoradiotherapy and 5 DRGs in day hospital. New classification criteria have been introduced into the DRG model for attributing the case to a certain DRG, in addition to the medical service used before. The number of fractions became a new criterion for radiotherapy, the number of fractions and the international non-proprietary name of the drug were proposed for chemoradiotherapy. A wider range of DRG’s weight coefficients was calculated, which allows more differentiated reimbursement of the costs of medical care provided by medical organizations depending on the method and the regimen used.
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institution Matheson Library
issn 2413-9432
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publishDate 2020-02-01
publisher Non-profit partnership for development of domestic photodynamic therapy and photodiagnosis "Russian Photodynamic Association"
record_format Article
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spelling doaj-art-8e691b5d84e44f39b35a1ce22b700f242025-08-04T13:14:24ZrusNon-profit partnership for development of domestic photodynamic therapy and photodiagnosis "Russian Photodynamic Association"Biomedical Photonics2413-94322020-02-0184364610.24931/2413-9432-2019-8-4-36-46192New approaches to formation of diagnosis-related groups for payment for radiotherapy and chemoradiotherapy based on clinical guidelines with the use of standardized modules of healthcareYu. A. Ledovskikh0E. V. Semakova1V. V. Omelyanovskiy2A. A. Kravtsov3E. A. Prokhorovich4M. V. Avxentyeva5I. A. Zheleznyakova6A. V. Petrovskiy7The Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian Federationhe Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian FederationThe Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian FederationThe Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian FederationThe Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian FederationThe Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian Federation; Sechenov First Moscow State Medical UniversityThe Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian FederationSechenov First Moscow State Medical University; National Medical Research Center of Oncology named after N.N. Blokhin of the Ministry of Health of RussiaThe article presents a methodology and results of developing diagnosis related groups (DRGs) for the cases of healthcare provided with the use of radiotherapy and chemoradiotherapy for malignant neoplasms in Russian Federation. A key element of the methodology is the standardized module of healthcare (SM) which allows calculating the tariffs for medical care in accordance with clinical guidelines. As a result of the application of the new methodology, in 2019, changes were made to the DRG model in terms of payment for radiotherapy and chemoradiotherapy. The changes included developing 10 DRGs for in-patient radiotherapy and 10 DRGs in day hospital; 7 DRGs for in-patient chemoradiotherapy and 5 DRGs in day hospital. New classification criteria have been introduced into the DRG model for attributing the case to a certain DRG, in addition to the medical service used before. The number of fractions became a new criterion for radiotherapy, the number of fractions and the international non-proprietary name of the drug were proposed for chemoradiotherapy. A wider range of DRG’s weight coefficients was calculated, which allows more differentiated reimbursement of the costs of medical care provided by medical organizations depending on the method and the regimen used.https://www.pdt-journal.com/jour/article/view/388radiotherapychemoradiotherapydiagnosis related groupstandardized module of healthcareclinical guidelinesstandard of medical care
spellingShingle Yu. A. Ledovskikh
E. V. Semakova
V. V. Omelyanovskiy
A. A. Kravtsov
E. A. Prokhorovich
M. V. Avxentyeva
I. A. Zheleznyakova
A. V. Petrovskiy
New approaches to formation of diagnosis-related groups for payment for radiotherapy and chemoradiotherapy based on clinical guidelines with the use of standardized modules of healthcare
Biomedical Photonics
radiotherapy
chemoradiotherapy
diagnosis related group
standardized module of healthcare
clinical guidelines
standard of medical care
title New approaches to formation of diagnosis-related groups for payment for radiotherapy and chemoradiotherapy based on clinical guidelines with the use of standardized modules of healthcare
title_full New approaches to formation of diagnosis-related groups for payment for radiotherapy and chemoradiotherapy based on clinical guidelines with the use of standardized modules of healthcare
title_fullStr New approaches to formation of diagnosis-related groups for payment for radiotherapy and chemoradiotherapy based on clinical guidelines with the use of standardized modules of healthcare
title_full_unstemmed New approaches to formation of diagnosis-related groups for payment for radiotherapy and chemoradiotherapy based on clinical guidelines with the use of standardized modules of healthcare
title_short New approaches to formation of diagnosis-related groups for payment for radiotherapy and chemoradiotherapy based on clinical guidelines with the use of standardized modules of healthcare
title_sort new approaches to formation of diagnosis related groups for payment for radiotherapy and chemoradiotherapy based on clinical guidelines with the use of standardized modules of healthcare
topic radiotherapy
chemoradiotherapy
diagnosis related group
standardized module of healthcare
clinical guidelines
standard of medical care
url https://www.pdt-journal.com/jour/article/view/388
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