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
• Pages: 441-452

Performance and Risks in the European Economy

441

Diagnosis Related Groups System - Managerial Tool for Estimating the

Cost of Hospital Services (Empirical Study)

Carmen-Mihaela Creu

1

, Victoria Gheonea

2

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).

1

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

2

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.