[Experiences with the Introduction of Diagnosis Related Groups (DRG) in the Hungarian Ophthalmology]

The aim of our investigation is to analyse the effect of the introduction of the DRG (Diagnosis Related Groups) principle on the financing of ophthalmology care including the analysis of market share of ophthalmology.

Data of the study derive from the financial database of the Hungarian National Health Insurance Fund Administration (OEP) containing the monthly activity reports of health care providers. The financing of acute hospital care in Hungary is based on a case-mix system called Homogeneous Disease Groups (Homogén Betegségcsoportok, HBCS). The analysis covers the period between 1995 and 2003. We used the following indicators in order to analyse the market share of ophthalmology: financial cases (patients), DRG costweights and nursing days (length of stay).

From the DRG costweights - serving as a base value for financing - the market share of ophthalmology was 3.3 - 3.5 % in 1995 - 1996, but decreased to 2.6 - 2.7 % in 1997 - 1998, and after a gradual increase since 1999 it went up to 3.4 % in 2002 - 2003. The market share of ophthalmology from financial cases (patients) increased from 3.1 - 3.2 % in 1995 - 1996 to 3.8 - 3.9 % in 2002 - 2003. From the total number of nursing days ophthalmology had a market share of 2.4 - 2.6 % in 1995 - 1996, which showed a further decrease to 2.2 - 2.3 % in 2002 - 2003. The average length of stay in ophthalmology decreased from 8 days (1995) to 4 days (2003).

The frequent changes of the Hungarian DRG system had a significant effect on the financing of Hungarian ophthalmology care. The continuous changes in the regulation of financing and reimbursement represent a big challenge for ophthalmology.