Vad kostar en förlossning, egentligen? : Analys av DRG-processen på en gynekologisk mottagning

Sammanfattning: The public sector in Sweden has throughout the years undergone some majorchanges, new government ideals has been implemented in order to increase efficiencyand cost awareness. There is a new governance model that is called New PublicManagement and aims to introduce a similar governance model as compared to theones being used in the private sector. This was done in order to increase the publicawareness and counteract the rising costs within the public sector. The reason behindthis study is to understand how New Public Management affects the Swedishhealthcare system. In order to investigate this, we studied the DRG-Process at ahealthcare clinic specialized in gynecological activities. By studying the DRG-processwe would like to understand how the process is applied and how offensive qualitydevelopment potentially could affect the process. In order to answer the studyquestions, observations and interviews has been conducted with doctors, secretariesand other staff that’s involved or in any other way possess knowledge of the process.The DRG-process is initiated by a doctor that dictates all the actions performed on apatient, a secretary then transcribes and encodes the actions. The process ends whenthe doctor signs the transcribed dictation. The performance of the process is affectedby the vastly varying sub-operations within the process, which affects the efficiency ofthe process. The process is also affected by the absence of a well-defined governancemodel.The doctor and secretary departments work independently from each other, this isnot an efficient process as their work is not well integrated. As DRG is used as acompensation system, the focus is on increasing the compensation, this shows thatthere is a major misconception amongst the employees within the clinic as to how theDRG-system actually works.We believe that many of the flaws we identified within the DRG-process could beeliminated or improved by introducing Offensive quality enhancement. According toBergman and Klefsjö (1995, 25), Quality enhancements consists of five base elementsand all five of these elements must be applied in order to gain an optimal advantageout of the model.