Epidemiology: Open Access
Open Access

Abstract

Diagnosis Related Groups (DRGs) are a electronic patient classification system that allows hospital homogenize the product
to compare the performance of specialists care, reduce the variability of medical practice, improve clinical management
and make transparent the payment system. DRGs are used in many countries and would be useful for the Colombian Health
system. However, attempts to introduce DRGs in Colombia were unsuccessful. Only eight of fifty high complexity hospitals
have DRGs, which makes it an innovation. The existing literature is abundant in the use of DRGs, but is scarce on the reasons
for accepting or rejecting DRGs in hospitals. The aim of our study was to explore the determinants for non-implementation
of DRGs in hospitals in Colombia. We use a qualitative case study approach to analyze the perceptions of the directors of six
hospitals with and without DRGs in Bogota. The theory of diffusion of innovation was the theoretical basis of the interview
applied. It was found that the directors had similar perceptions of the determinants. Although DRGs are perceived as positive,
obstacles to implement it were found in two levels: organizational (threats to physician autonomy, culture of non conflict,
poor diagnostic coding and emphasis on processes rather than results) and institutional (imperfect health market, negotiation
between insurers and providers based on procedures not on diagnoses and finally lack of public policies pro DRGs). It was
concluded that unless there is a public policy that leverages the issue, the possibility of DRGs in Colombia is not in the near
future.

Biography

Sandra Milena Agudelo-Londono is a Health information system Manager and has a Master in Epidemiology from Universidad de Antioquia in Colombia. She is a
Proffesor of Health information systems and Managerial Epidemiology in Pontificia Universidad Javeriana, Bogotá. She has published several papers in reputed
journals and has been serving as the Editorial Board Member of Gerencia y Políticas de Salud Journal in her country.