Abstract:

For the continuity of the supply of health care, health institutions must be in a sustainable financial position. The method used in reimbursement to health services servers directly affects the financial sustainability of institutions. Therefore, the process of deciding on the methods of refund used in the health systems of the countries requires great attention. In order to ensure that the quality of the health services is not understood, the method of reimbursement used must be in the character that provides a fair distribution of resources between health institutions. This study aims to explain the methods of refund used in health care services and emphasize the importance of refund based on the Diagnostic Related Groups, which is an example of the method of payment per case. by T.C. The A2 group associated with the Ministry of Health is calculated using the Monthly Diagnosis Related Groups data of a general hospital for 2018. The average annual case karma index of the hospital was 1,01. The Monthly BasedHigh Case Karma Index is 1.13 in December with the Indicate of Case Karma in December with 0.91 in May. With the use of the method of refund based on the Diagnostic Related Groups in the refund of health services, it is expected that the institutions will be able to make their service proposal plans with more reliable data, to obtain funding according to the services they offer, and to make national and international comparisons between the health institutions. Thus, it is believed that both the payment institution and the health service provider can be protected from cost risks or some other risks that may occur.

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