Covid-19 and Reimbursement Mechanisms in Medical Economics; Retrospective(ffs) or Prospective(drg) Payment Healthcare Systems, Which One?

Abstract

index. COVID-19 disease has economic and financial effects at both macro and micro levels. At the macro level, the economic effects of this pandemic disease have emerged as a shock or economic crisis, meaning that it has affected the financing and economic structure of countries, in other words, the economic pattern and turnover worldwide. At the micro-level, funding sources and health care reimbursement mechanisms in hospitals have been severely affected. In this study, health care repayment and financing systems in the health sector, especially hospitals, were studied. In addition, are retrospective health financing and repayment systems better or prospective repayment systems in times of crisis or economic shock caused by COVID-19 disease? The types of financing mechanisms and current repayment methods, depending on the type of health system as well as other conditions and requirements of each country, have strengths and weaknesses [1-3]. The results of a study (Ahangar et al ., 2021) at Iran University of Medical Sciences show that before and after COVID-19 disease, hospitals with prospective repayment systems (such as DRG, Global, Per Capita mechanisms) compared to hospitals with retrospective repayment systems were more efficient in controlling costs and resources, as well as better managing the quality of hospital care.