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Payment Mechanisms for Discontinued Treatment Cases in Hospital

Student: Brutova Anna

Supervisor: Sergey Shishkin

Faculty: Faculty of Social Sciences

Educational Programme: Health Care Administration and Economics (Master)

Year of Graduation: 2016

Payment methods for hospital health care according to the groups of diseases (including DRG) leads to determine the special rules for reimbursement of medical expenses for treat cases that have not been completed. The paper analyzes the payment methods of short length of stay cases in hospitals, which international practice and subjects of Russian Federation apply. The analysis of the Russian Federation laws has shown a variety of approaches to the definition of discontinued cases and, therefore, the differentiation of its payment mechanisms. During the statistical analysis of the structure of discontinued cases in some regions of the Russian Federation the influence of payment mechanism was noted. A comparative analysis of discontinued cases payment mechanisms identified the advantages and disadvantages of different methods. In order to organize the optimal expenditure of compulsory health insurance the provisions for payment of discontinued cases with short length of stay are codified. Payment algorithm does not contradict federal laws, but it is complemented by the conclusions of the comparative analysis results.

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