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Modelling of Healthcare Expenditures on Management of Patients with Diabetes Mellitus for Reimbursement under Diagnosis-Related Groups

M. V. Shestakova1, O. V. Zelenova2, I. Ya. Yarek-Martynova1, S. I. Abramov2, O. K. Vikulova1, O. I. Karpov3

1. National medical research center for endocrinology of Ministry of Health of the Russian Federation, Moscow, Russian Federation

2. Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russian Federation

3. JSC Sanofi Russia, Moscow, Russian Federation

To improve the management of patients with diabetes mellitus (DM), a change to the current system of reimbursement for completed case treatment of this group of patients, followed-up in the outpatient departments of the hospitals, based upon obligatory health insurance fund was introduced.

A new Diagnosis-Related Group (DRG) «Follow-up of patients» was proposed and proved to be listed in the medical register. Calculations based on the model of a patient with DM, who needs to be followed up and potentially has been diagnosed with complications of the disease. The model includes a patient’s stay in an outpatient department of the hospital for three days to be diagnosed and treated.

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