PSU25 THE CHANGE OF CASE MIX INDEX IN THE PUBLICLY FINANCED HUNGARIAN ONE-DAY SURGERY CARE

Abstract

In the past decade, the progression of one-day surgery was significant in Hungary, because there were few important initiations in the Hungarian health policy which were able to facilitate the spreading of one-day surgery from the beginning of 2010s’. The aim of the study is to evaluate the changes of Case Mix Index (CMI) within the Diagnosis Related Groups (DRG) system in publicly financed Hungarian one-day surgery care between 2008-2018. Data were provided from the financial database of the National Health Insurance Fund Administration of Hungary. The database of the research consisted all publicly financed one-day surgery case and DRG cost weight numbers related to the type, name and financing code of health care institutes between 2008-2018. During the examined period, 2,322,879 public financed one-day surgery cases, and 1,241,708 DRG cost weight numbers were reimbursed by the National Health Insurance Fund Administration of Hungary. The number of cases increased 275%, meanwhile the DRG cost weight numbers increased 370% between 2008-2018. Nationally, the mean CMI was 0.52307 (SD=0.4428- 0.6032) between 2008-2018. It was the highest in 2018 (CMI=0.5989) and the lowest in 2008. (CMI=0.4409). The changes of CMI from the viewpoint of the type of health care institutes were rather different. The CMI of universities (0.6388), county hospitals (0.5232), national institutes (0.5977), and specialized hospitals (0.5989) were above the national average (0.5346). According to our results, the type of health care institute influenced the value of CMI (p=0.001). The changes of CMI among universities were rather different. We could verify that the constant increase in the utilization of one-day surgery did not affect the increase in CMI on the national level, but the type of the health care institute influenced the value of CMI.