The Impact of DRG-Based Payment Reform on the Efficiency of Medical Care for Patients with Myocardial Infarction: Evidence from Georgia.

Abstract

In Georgia, a prospective financing system for hospital services using diagnosis-related groups (DRGs) was introduced in 2022 to increase the efficiency and transparency of the healthcare system. The purpose of this study is to evaluate the impact of DRG-based hospital reimbursement on the efficiency of medical care for patients with myocardial infarction. Hospitalization data from three large hospitals in Georgia before and after the introduction of DRGs, covering the period from 2021 to 2024, were analyzed. The study found that the implementation of DRGs in cardiology hospitals reduced length of stay, readmission, and mortality rates. Although the prices for nosologies have increased, patients' direct out-of-pocket payments have decreased, thereby improving financial access to medical services. The introduction of the DRG payment system had a positive effect on patient financial accessibility.