Designing a model for implementing diagnosis-related groups in Iran: An action plan approach.

Area of Science:

• Health Services Management
• Health Economics
• Healthcare Policy

Background:

• Diagnosis-Related Groups (DRGs) implementation enhances healthcare efficiency, treatment quality, and cost reduction globally.
• Iran lacks a coherent model for DRGs implementation, necessitating a context-specific plan.

Purpose of the Study:

• To develop a DRGs-based implementation action plan model tailored for Iran.
• To address the absence of a structured approach for DRGs adoption in the Iranian healthcare system.

Main Methods:

• An applied, descriptive cross-sectional study conducted in three stages.
• Stage 1: Review of international DRGs implementation studies.
• Stage 2: Model design for Iran's DRGs action plan.
• Stage 3: Model validation using the Delphi technique.

Main Results:

• A DRGs-based implementation action plan model for Iran was designed.
• The model comprises three primary axes: strategic approach, technical dimensions, and executive institutions.
• Expert validation achieved 94% agreement on the model's axes.

Conclusions:

• Tailoring DRGs implementation plans to national contexts is crucial.
• Recommended pilot implementation at the hospital level, followed by gradual national rollout in Iran.