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MY-DRG Case-Mix a Tonic for Healthcare Industry
2011/12/08
ONE of the key problems faced by healthcare industry is the escalating healthcare costs
and variance in healthcare delivery.
This is especially in developing countries leading to inappropriate treatment, longer
length of hospital stays, low patient satisfaction and higher costs.
Researchers from the Department Of Community Health Faculty Of Medicine, Universiti
Kebangsaan Malaysia (UKM) Medical Centre, have come up with a healthcare management
system software that improves care and reduces costs for better healthcare services.
Prof Datuk Dr Syed Mohamed Aljunid of UKM, who is also a senior research fellow of
United Nations University-International Institute of Global Health (UNU-IIGH), said its product,
Case-Mix Solutions Software or MY-DRG Case-Mix offers a proven system that delivers
dramatic cost savings to healthcare payors (government and private insurance companies).
At the same time, it improves the quality of healthcare through best-practice pathways
and offers a cost effective solution versus currently available healthcare software systems.
"We provide healthcare management software and training to governments (payors) and
hospitals in developing countries," he said.
He said its knowledge-based software enables hospitals to provide higher quality healthcare
at 19 per cent cost savings.
Prof Syed Mohamed said with its healthcare management system, an average 500-bed
hospital can reduce expenses by RM16.5 million per year (RM 33,000/bed/year). "A
government in a country with 150 hospitals like Malaysia can save RM 2.5 billion per year,"
he said.
Prof Syed Mohamed said Indonesia has 1,200 hospitals, Vietnam has 956 and Mongolia
has 250. This is based on a one-year in-depth study of an actual tertiary hospital in Malaysia.
Explaining further on Malaysian Diagnosis Related Grouping Software or (Malaysian-DRGs),
he said it was developed by researchers in UNU-IIGH and ITCC (International Training
Centre on Case-Mix and Clinical Coding) of Universiti Kebangsaan Malaysia (UKM).
"The IP ownership lies with UKM and UNU-IIGH. Using the United Nation University-Case-mix
Grouper as the grouping engine, the MY-DRG was specially developed for as a provider
payment system," he said.
It has an in-built mechanism for in-patient and out-patient services in the Malaysia
health system.
The MY-DRG uses UNU Case-mix Grouper which covers all types of patient care.
The system gives options to use diagnosis, procedures, drugs, investigations and
prosthesis in the classification.
It uses costing template software for development of hospital base-rates, and the
national tariff for health services.
The system also monitors outcome of care provided and benchmarks the cost and
quality of care in hospitals and clinics.
"Once it is launched, the National Health Insurance Programme will use the MY-DRG
Case-Mix system as a method to pay health providers.
"The system provides total solution for Case-Mix, covering digital coding tool, costing
tool and grouper functionalities," said Prof. Syed Mohamed.
The advantages and unique selling points of the system is that it is a Universal Grouper
Software: Covers all types of services provided in hospitals and clinics, including in-patient
and out-patient services covering acute, subacute and chronic cases.
The system is a dynamic grouper, which means the number of groups and severity of
cases are not static and can be customised according to the needs of different countries
in the world.
"As an advanced grouper, the MY-DRG's diagnoses and procedure classifications can
incorporate future changes including revised and updated ICD-10 & ICD-11 and New
International Procedure Classification System.
The system is currently being used in 2,480 hospitals - 1,200 government hospitals in
Indonesia, 1,020 government hospitals in the Philippines and 250 government hospitals
in Mongolia. As for the private insurance market, 10 hospitals in Uruguay have used this
software.
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