Klin Onkol 2004; 17(Suppl 1): 31-36.
Summary: During the last 20 years there have many new methodologies aimed at quality enhancement occurred in the field of healthcare services. These are: systems of clinical classification „case mix“ and DRG and evaluation methods of health technologies (HTA – Health Technology Assessment). This article deals with some of key principles common for these methods and with practical experience. The up-to-date question in the Czech healthcare system is a repeated effort to implement a DRG system (first AP DRG, later IR DRG) as a system of reimbursement. On the contrary, the HTA method is brand new in the Czech healthcare system. Therefore this article is aimed at confrontation of needs of oncology and of these relatively new methodological domains. The common goal of both DRG and HTA is an achievement of higher clinical cost efficiency. The DRG system in its 20 years long history has been trying to find a relation between standardized clinical categories (diagnoses, procedures) and costs. The HTA method is aimed at systematized effect evaluation of a concrete healthcare approach comparing it with consumed resources. The DRG uses rather aggregation of similar attributes and phenomena and determination of usual values of their parameters. HTA goes far deeper into procedures details and specific characteristics. Both methods try to systematize and standardize basic clinical and economic categories, work with large data volumes and use information technologies for this purpose.
