ENHANCING COST ASSESSMENT IN HEALTHCARE: A CASE-MIX VS TRADITIONAL COSTING APPROACH

Abstract

Background: Healthcare systems strive to provide high-quality services while optimizing resource utilization and cost-effectiveness. Achieving these goals necessitates using scientific tools or methodologies to assess costs before implementing cost-reduction measures. Diagnosis related group DRGs) which is also called case-mix is a costing method in health. This study focused on a secondary hospital located in the Jazan region of Saudi Arabia. Our goal was to conduct a patient-level healthcare service cost analysis using the Case-mix system. The purpose of this current study was to identify the cost of DRG for each inpatient and compare it with previous price of services of inpatients. Materials & Methods: To achieve this, we conducted a retrospective cross-sectional analysis, classifying healthcare service costs they incurred throughout the year 2018 for inpatients diagnosis and methods. Results: Our findings revealed a notable disparity between DRG-based costing, amounting to SAR 138,147,926, and the average costing, which stood at SAR 118,799,359. The DRG-based costing method demonstrated excellent reliability and better representation of patient services. As a result, we recommend its use for reimbursement purposes.