Abstract
The trend for quality, efficient, and productive financing of health service providers, especially Intensive Care Units (ICUs), has become increasingly evident in recent decades. In this study, we investigate the prospective reimbursement method, per case of hospitalization in the ICU, according to the Diagnostic Related Groups (DRGs), in the OECD countries, as well as the appropriateness of using the method, in the particular environment of the ICU. A systematic review of papers published up until July 2022 was conducted. The search was performed on PubMed, Medline, Scopus, ScienceDirect, and Google Scholar. The criteria for inclusion in this review were the calculation by researchers of the appropriateness of using DRGs in the ICU, as a method of reimbursement, through comparison with the actual cost of hospitalization of patients in the ICU. Only sixteen(16) of the scientific papers retrieved met the criteria for inclusion in this review. Ten(10) studies assessed the appropriateness of applying DRGs as a reimbursement method in adult ICUs and six(6) assessed the appropriateness of applying DRGs as a reimbursement method in Neonatal Intensive Care Units and pediatric ICUs. Discrepancies were observed between the actual cost of hospitalization and the reimbursement amount in all categories of ICUs. Finding the right DRG system, combined with other financing methods, would be a useful policy tool to help manage finances, contain costs, and provide quality health services.
