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Physicians and DRGs. Hospital management alternatives
Evaluation & the Health Professions
|November 5, 1988
Summary
Physicians strongly oppose new hospital management strategies, like bedside budget balancing, introduced by Medicare's diagnostic-related groups (DRGs) payment system. Collective protocols show limited physician acceptance but minimal expected success.
Area of Science:
- Health Services Research
- Healthcare Management
- Public Health Policy
Background:
- Rising healthcare and hospital costs strain federal programs like Medicare.
- The prospective payment system based on diagnostic-related groups (DRGs) was implemented in 1983 to control Medicare expenditures.
- The DRG system has sparked significant debate within the healthcare community.
Purpose of the Study:
- To examine physician opinions on four management alternatives necessitated by the DRG system.
- To assess the perceived impact of these alternatives on the healthcare system.
Main Methods:
- A random sample of 838 physicians from the West North-Central region was surveyed.
- Physicians' opinions on increased physician monitoring, profit-loss sharing, collective protocols, and bedside budget balancing were collected.
Main Results:
- Physicians expressed strong negative opinions regarding the proposed management alternatives.
- A significant negative impact on the healthcare system was anticipated by physicians.
- Development of collective protocols was the most acceptable alternative, though with limited expected success.
Conclusions:
- Physician resistance to DRG-driven management changes poses challenges for implementation.
- Collective protocols may offer a viable, albeit limited, path forward for physician engagement.
- Further research is needed to explore physician-supported strategies for cost containment within the DRG framework.
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