Diagnosis-Related Group-Based Financing of Gynecologic Oncology Clinics: A Systematic Review.

Abstract

Background/Objectives: Diagnosis-related group (DRG)-based financing, a subcategory of case-based payment models, has been established as the primary reimbursement scheme in most high-income countries. Almost 40 years thereafter, the impact of the reform on gynecologic oncology funding and recompensation has not been clearly elucidated. This systematic review aims to address the scarce bibliographic data, consolidate the information regarding DRG-based systems in gynecologic oncology, evaluate the advantages and challenges of its implementation worldwide, and examine alternative and complementary recompensation schemes in this context. Methods: A stringent and comprehensive literature review of original articles using online databases (Google Scholar and Pubmed) yielded 173 potential results. Results: These were further assessed for relevance and eligibility and, finally, an in-depth investigation of 15 articles was conducted. We concluded that, despite the fact that DRG-based financing may be beneficial in most healthcare scenarios, the reimbursement scheme is challenged in the context of gynecologic oncology. Conclusions: An innovative approach comprising a combination of the values of case-based and value-based payment models would extend healthcare services beyond acute treatments and propose new perspectives in holistic healthcare provision in a financially sustainable environment.