The structural transformations experienced by the health sector in recent years have required new visions and attitudes of hospital management. Among them is the quest to increase the efficiency of operations, improve the quality of care, reduce waste and generate qualified information.
These are some of the pillars of DRG Brazil methodology, specialized in health management, with a focus on quality of care and containment of unnecessary expenses. “Through the technology provided by the DRG platform, public and private hospitals have been improving their planning, monitoring, assessment of the quality of care and efficiency in the use of resources and services in the hospital environment. With the actions adopted and with efficient practices, waste is eliminated, leaving hospitals more efficient, being able to serve more patients and offering more quality. In short, we will be able to save more lives”, explains Dr. Renato Couto, president of Grupo IAG Saúde and co-founder of DRG Brasil.
DRG Brasil is part of the recent partnership launched QualifiesSUS that together with the Central dos Hospitals de Minas Gerais, Unimeds MG Federation, Graduate Medical Sciences, Unimed Foundation/Faculty, National Accreditation Organization (ONA), Planisa and the Brazilian Society of Health Information Analysts (SBAIS) provide products and services to hospitals to meet the requirements of the Valora Minas, Hospital Care Policy of the Government of the State of Minas Gerais.
Value based system
According to Planisa – a company specializing in health management solutions and Valor Saúde DRG Brasil, 53% of Brazilian hospital expenses are waste that can be controlled. In addition, if these flaws are corrected, assistance gains could reach R$ 38.9 billion for the sector. “A value-based healthcare system is good for everyone. The patient reduces their physical and psychological damages and their costs. Society guarantees greater access to the health system and increases the competitiveness of its economy, providers can be better remunerated and funders more sustainable if they control waste”, highlights Couto.
The main focus of management is to improve organizations’ processes by combining consulting and technology to simplify, ensure accessibility, change results quickly and innovate based on science and with a focus on transforming customer experience. “The platform, in addition to helping to share information and knowledge, makes the health system deliver more and more results, always having the patient at the heart of everything”.
Changing this reality in practice means investing in actions such as optimizing bed turnover, better management of the hospitalization period, monitoring of chronic and highly complex patients, by scheduling return appointments in advance, avoiding readmission; the expansion of the population’s access to public health services; and the valorization of primary care, preserving the patient from the aggravation of diseases that may lead to hospitalization.
About the DRG methodology
The DRG methodology – acronym for Related Diagnostics Groups, from the English Diagnosis Related Groups – proposes to systematize the resources used by the hospital for each inpatient. It is used to improve care, the remuneration model and the management of health as a whole by governments, hospitals and operators in numerous countries.
“Delivering value must be the goal of health systems in order to avoid waste and failures that harm patient care and the results achieved. Health value is determined by the quality of care divided by the cost, aligned with a positive patient experience in their trajectory in the health system. The inverse of value is waste”, declares Tania Grillo, also president of Grupo IAG Saúde and Co-founder of DRG Brasil.
The design and development of the DRG methodology began in the 1970s, at Yale University, in the United States, under the coordination of professors John D. Thompson and Robert B. Fetter. The first scale application took place this decade in the state of New Jersey. In 1982, the program was implemented in Medicare, the health insurance system managed by the US government.
At the end of the 1980s, the methodology was disseminated to other countries, with adjustments to the specific demands of the local reality. In Brazil, studies began in 1991; In 1997, Brazilian researchers tested the DRG classification for hospital management in the region of Ribeirão Preto (SP), both in public and private institutions: they concluded that the method provided information about the profile of the complexity of hospital care and contributed to the monitoring and hospital improvements.
Today, with the DRG methodology fully adjusted to the Brazilian profile, care outcomes and resource consumption become comparable and predictable. This is because patients grouped in the same DRG (care product) have similar clinical and risk characteristics, determining the use of resources – daily allowances and supplies – which are also similar.