ArticleCost effectiveness and resource allocation : C/E2026
Ghana's Diagnosis Related Grouping (G-DRG) tariffs versus hospital charges: implications for inpatient care financing at a secondary hospital in Ghana.
Article in Cost effectiveness and resource allocation : C/E, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundGhana introduced the National Health Insurance Scheme (NHIS) in 2003 as a means of achieving Universal Health Coverage. The Ghana-Diagnosis Related Groupings (G-DRG) is one of the payment mechanisms used to reimburse providers for services and procedures. However, evidence suggests that the amount reimbursed for services through the G-DRG tariffs may be lower than the market prices for same, creating a financial gap that concerns providers.
objectiveThe study assessed the financial implications of the G-DRG payment system on service delivery for inpatient services between 2018 and 2022 at the Greater Accra Regional Hospital in Ghana.
methodsThe study adopted a descriptive cross-sectional study design approach to gather and analyze the data. The 2021 annual performance report of the hospital was used to identify the top hundred reported inpatient admissions. Institutional data on G-DRG tariffs issued by the National Health Insurance Authority (NHIA) and the approved hospital charges for managing sampled medical conditions were extracted. The top ten conditions from the sample were used to determine the price differentials between G-DRG tariff and hospital charges for same conditions on admission.
resultsThe study found that 3,323 (63.5%) of the top 10 conditions on admission in 2022 were related to children, with neonatal jaundice constituting the highest (1,177; 23%). Gastroenteritis, Septicaemia, hypertension and appendicitis were the common adult conditions on admission. While the G-DRG tariffs reported price increment every other year (16%), hospital price increment was unstable ranging from 20% to 58%. Nonetheless, the study found a cumulative financial gain to the facility of 23% on the top ten inpatient medical conditions over the five-year period.
conclusionWhile the G-DRG had positive price differentials over the five-year period, ensuring macroeconomic stability is important in maintaining the gains and supporting the financial viability of the G-DRG payment system. Future research should look investigate the relationship between price differentials and average length of stay in admissions. CLINICAL TRIAL NUMBER: Not applicable.
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