Methodology of forming a model of diagnosis-related groups for cases of medical care using surgery performed by laparoscopic access

Background. A wide range of endosurgical treatment methods in various medical care profiles and the need for uniformity of calculations required developing a unified approach to the formation of diagnosis-related groups (DRGs) for cases of surgical medical care provided by laparoscopic access.

Objective: to develop a methodology for the formation of a DRG model for cases of medical care using surgery performed by laparoscopic access in the context of the following medical care profiles: “coloproctology”, “urology”, “surgery (abdominal)”, “obstetrics and gynecology”, “pediatric urology-andrology”, “pediatric surgery”.

Material and methods. The methodology for the formation of DRGs to pay for cases of medical care using surgery with laparoscopic access included the implementation of several stages: analysis of scientific and methodological documents, analysis of regulatory legal documents on the research topic, standardized expert survey of federal and regional medical centers (carried out in August 2023), formation of DRGs in the context of each profile, and calculation of cost-intensity coefficients.

Results. Due to significant increase in the cost-intensity coefficient in nine newly formed DRGs to pay for cases of medical care provided by surgery with laparoscopic access, financial support of this type of surgical medical care almost doubled. The formed DRGs with appropriate cost-intensity coefficients were included in the Program on State Guarantees to Deliver Free Medical Care to the Citizens for 2024 and for the planning period of 2025 and 2026.

Conclusion. The methodology of forming DRGs to pay for cases of medical care using surgery performed by laparoscopic access with a unified methodology for calculating costs for medical care provided an integrated approach to the process of forming DRGs for cases of surgical medical care, and unification of calculations for different medical care profiles.

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