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Title:Modeli plačevanja zdravstvenih storitev s poudarkom na plačevanju po skupinah primerljivih primerov v Sloveniji
Authors:Marušič, Dorjan (Author)
Ceglar, Jakob (Author)
Prevolnik Rupel, Valentina (Author)
Files:URL http://www.ivz.si/javne_datoteke/vestniki/datoteke/228-Prevolnik.pdf
 
Language:Slovenian
Work type:Not categorized
Tipology:1.01 - Original Scientific Article
Organization:FHŠ - Faculty of Humanities
Abstract:Plačevanje zdravstvenih storitev izvajalcem zdravstvene dejavnosti v Slovenijipoteka po modelu skupin primerljivih primerov, ki je bil uveden leta 2003. Pred tem so se v Sloveniji uporabljali različni modeli plačevanja, od plačevanja po storitvah, po bolnišničnooskrbnih dnevih in po primerih. Prav zaradi slabosti in pomanjkljivosti, ki so jih različni sistemi prinesli, se jev Sloveniji uveljavil sistem skupin primerljivih primerov (SPP), ki je trenutno v veljavi. Namen članka je pregledati in klasifikacirati sisteme financiranja zdravstvenega varstva v Sloveniji glede na izbrane kriterije ter izpostavitev prednosti in slabosti posameznih skupin modelov. V nadaljevanju članek opisuje in analizira prednosti in pomanjkljivosti modela plačevanja po skupinah primerljivih primerov ter prikaže njegov zgodovinski razvoj in uporabo. Članek zaključi z zgodovinskim pregledom uveljavljanja sistema SPP v Sloveniji.
Keywords:skupine primerljivih primerov, sistem financiranja, izvajalci, primeri, potrebe, izidi, financiranje, zdravstveno varstvo, bolnišnice
Year of publishing:2009
Number of pages:str. 177-183
Numbering:Letn. 48, št. 4
ISSN:0351-0026
UDC:614.2
COBISS_ID:1024170836 Link is opened in a new window
Views:1990
Downloads:38
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Secondary language

Language:English
Abstract:The reimbursement of inpatient health care in Slovenia is based on the diagnosis related groups model (DRG), which was introduced in 2003. In earlierdays in Slovenia different reimbursement models were used, like fee forservice model, payment according to hospital days and payment per number ofinpatient cases. The DRG system was introduced to Slovenia in order to adress the shortcomings and weaknesses of the previous reimbursement systems. The purpose of this article is to classify and analyze the health care reimbursement systems in Slovenia according to the selected criteria and determine the pros and cons of each group of systems. Further on, the article describes the development and use of DRG reimbursement model and presents its implementation and developmental path in Slovenia.
Keywords:diagnosis-related groups, reimbursement, health care providers, case, needs, outcome assessment, financing, health care, hospitals

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