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Comparing hospital compensation to actual costs based on the Greek Diagnosis-Related Group system in ophthalmology

Tzamalis, Argyrios, MD, PhD, MA, FEBO1,2; Chionos, George, MD1; Brazitikos, Periklis, MD, PhD1; Tsinopoulos, Ioannis, MD, PhD1; Dimitrakos, Stavros, MD, PhD1; Talias, Michael A., MD, PhD2

International Journal of Evidence-Based Healthcare: September 2018 - Volume 16 - Issue 3 - p 167–173
doi: 10.1097/XEB.0000000000000148

Purpose: The purpose of this study is to evaluate the effects of the new system of pricing medical services in the field of ophthalmology in Greece. In addition, it attempts to benchmark the system with respective interventions at an international level.

Materials and methods: The study deals with the implementation of the new system, presenting systematic pairing of ophthalmic coding with other coded information regarding registration and management. Statistical data analysis is performed related to the cost and, finally, proposals are formulated to improve the current system.

Results: A significant difference is noted in the quantitative and qualitative characteristics of the Greek system compared with internationally applied Diagnosis-Related Group (DRG) systems in the field of ophthalmology. The proposed funding for ophthalmic inpatient cases mostly meets real needs and costs of hospitals for supplies. Complicated cases, mainly in cataract surgery, increase the real cost and may cause a deviation depending on the rate of complications. In these cases, the average cost was 673.28 ± 58.7€ as opposed to uncomplicated cases (346.78 ± 21.3€), bearing a statistically significant difference (P < 0.001, Mann–Whitney test). The total compensation of the hospital was higher than the actual cost for surgical procedures covering the respective expenses.

Conclusion: Although the recently implemented compensation system for public hospitals mostly covers the actual cost for ophthalmic surgical cases, some deviations from the real needs are being identified. Several amendments could be applied to increase efficiency and improve the quality of health services provided by Greek hospitals.

12nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece

2Faculty of Economics and Management, Open University of Cyprus, Nicosia, Cyprus

Correspondence: Argyrios Tzamalis, MD, PhD, MA, FEBO, 2nd Department of Ophthalmology, Faculty of Medicine, Aristotle University of Thessaloniki, Papageorgiou General Hospital, 56403 Thessaloniki, Greece. Tel: +30 2313 32 39 39; fax: +30 2310 26 24 44; e-mail:

International Journal of Evidence-Based Healthcare © 2018 The Joanna Briggs Institute
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