Pediatric Inpatients Cost 2019-2023

Pediatric Inpatients Cost 2019-2023 - Study Report Serbia

Simo Vuković ^a, Nikola Savić ^a, Marina Topalovic ^a, Mirjana Milošević ^a

Introduction
In Serbia, the costs of all hospitalizations financed by the NationalHealth Insurance Fund have been monitored since 2019, when DRG payment model was introduced. In the serbian payment model, DRG coefficients are used to calculate the performance of acute hospitals. Since DRG coefficients for pediatrics are different and costs for pediatric patients differ, there is a need for constant monitoring of costs and coefficients adjustment. The following pathologies stand out amang other pediatric hospitalizations: care of newborns after expensive and complicated births, stays due to rare conditions and organ transplants.

Methods
Study shows a trend of costs over the period for children 0 - 18 years of age, including the distribution of costs by DRG categories, average cost of hospitalization, ALOS, casemix index, total consumption of drugs, consumption of medical supplies, and the average cost according to the most common DRGs.

Results
Distribution of total hospital costs among patients devided by age shows a relatively stable ratio over the years. The highest total annual cost is represented in the group with patients 0-1 years of age. The DRG category with the highest annual cost is the category of newborns, followed by categoriy of diseases and disorders of the nervous system. The age group from 14 to 17 has the highest consumption of medicines including medical and sanitary materials. The most common DRGs show the cost growth over the time. The average cost per invoice has increased in the last (2023) year. The case mix index is the highest in 2020 during the pick of the COVID-19 pandemic.

Discussion
In addition to monitoring total hospitalization costs over time, it is necessary to monitor costs for individual DRGs. Costs can depend on the introduction of new drugs and new technologies in the treatment. Not every cost increase is a problem or requires intervention. It is necessary to monitor and adjust the DRG coefficients based on the annual analyses, so that hospitals that exclusively treat pediatric patients are financially sustainable.

^a SECRP Serbia Emergency Covid Response Project, Serbia

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