Diagnosis Related Groups System - Managerial Tool for Estimating the Cost of Hospital Services (Empirical Study)

Author:Carmen Cretu - Victoria Gheonea
Position:Associate Professor, PhD, Danubius University of Galati, Faculty of Economic Sciences, Romania - PhD Student, 'Alexandru Ioan Cuza' University of Iasi, Romania
Performance and Risks in the European Economy
Diagnosis Related Groups System - Managerial Tool for Estimating the
Cost of Hospital Services (Empirical Study)
Carmen-Mihaela Creu
, Victoria Gheonea
Abstract: P ublic health services in Romania are in a complex a nd continuous process of reform, a major
priority of government. In the light of future trends of development of health car e, we can say that healthcare
is becoming more and more a "market" operating on the principle of supply and demand. The patient
becomes a cons umer; he is interested in health care and wants to be adept at maintaining and i mproving his
health. Therefore, the Romanian health sector must intensify efforts to develop management because success
and even its exis tence depend exclusively on an appropriate management system that continuousl y improves
to the needs of the pat ient (customer) and to the market economy. Thus, we considered it necessary for
costing approach in the health sector in Romania due to the high complexity of health services and the high
consumption of resources.
Key words: managerial accounting; public accounting; costs; health economics; financing
JEL Classification: M41; H83; I18
1. Introduction
Hospitals in Romania are currently facing a problem of low financing services, which no longer keep
pace with medical technology, demand for services growing and more diverse, need for salary
increases in public sector and the need to align to European standards for medical assistance. Given
that the national level has not yet performed a study of hospital care costs, indicating the need for
funding, cannot say with certainty that hospitals are underfunded or not.
On the other hand, neither hospital providers have developed a well-documented offer of services,
defining health care packages, which could help financier and patients in the purchase of services.
Bridge between the two poles (supplier and buyer of services) can be achieved by better defining the
types of services, manner and quality standards to which they should be provided and the appropriate
level of funding. If into a private health system, these elements come by itself, because the service is
defined first, then how much delivery, and then sets its price, in the public system, the principle of
universality and gratuity access to medical services makes this approach to come much later, or never
come (Haraga&urlea, 2009).
The purpose of our study is the one of the main concerns in lately of the hospital managers, namely: to
demonstrate that the Romanian public system of hospital services must estimate the economic
efficiency through a coherent system of costing. The approach it is not unrealistic in the context of the
emergence of profitable health care systems, so economically efficient, even if they are the majority of
hospital services under private management.
By appeal to the particularities of the health system in Romania, we present model costing hospital
services currently used in hospitals, based on the Diagnosis Related Groups System (DRGs).
Associate Professor, PhD, Danubius University of Galati, Faculty of Economic Sciences, Romania, Address: 3 Galati Blvd,
Galati, Romania, tel: +40372 361 102, fax: +40372 361 290, Corresponding author: carmencretu@univ-danubius.ro
PhD Student, "Al exandru Ioan Cuza" University of Ias i, Romania, Address: 11 Carol I Blvd, Iasi 7005063, Romania, Tel.:
+40 232 201035, Fax: +40 232 201106, e-mail: victoriagheonea@yahoo.com.

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