Changes in diagnosis-related group payment model in the Russian Federation in 2024
E. I. Rumyantseva, I.A. Zheleznyakova, O.S. Plakhotnik, F. S. Nikitin, T.S. Vakhrusheva, T.S. Aviaeva, A. V. Zuev, О. А. Волкова, J. A. Agafonova, D. V. Fedyaev, M. Avxentyeva, V. V. Оmelyanovskiy
Abstract
We actualized the content and/or weight coefficients of Russian diagnosis-related groups (DRG) for inpatient and day medical care payment. Costs of medicines were calculated using actual purchase prices. Thus the weight coefficients were recalculated for several DRG including admissions for antineoplastic therapy, chronic hepatitits C treatment and treatment with the use of genetically engineered biological drugs and selective immunosupressors. Three levels of patient treatment complexity coefficients were introduced to reimburse the cost of supportive therapy in oncology. Weight coefficients for payment for radionuclide therapy were recalculated. We actualized drug therapy regimens lists covered by DRG payment. It was made for antineoplastic therapy regimens and regimens of genetically engineered drugs and selective immunosuppressors. Charges for inpatient minimally invasive operations were increased via identifying 9 new groups. Payment approaches for immunization against respiratory syncytial infection were improved. The updated grouping algorithm of cases in oncology is described.