Incorporating Nursing Complexity into the DRGs System

The homogeneous diagnostic grouping system is a system of classifying patients based on diagnoses, clinical procedures, and resource utilization. It aims at rationalizing the management of available resources, ensuring effective and efficient care. The aim of this review was to investigate the need to incorporate nursing complexity into existing health care reimbursement coding systems. Through a brief description of the system of homogeneous diagnostic groups (DRGS), it proposes ways to substantially upgrade them, through the recognition of the complex contribution of nursing to the quality of the health services provided. Assessing the complexity of nursing care involves understanding, quantifying, and strategically managing all factors associated with ensuring high-quality care for patients. Existing reimbursement coding models are based almost exclusively on medical care provided, ignoring all factors that affects the quality of nursing care provided. According to the literature, the complexity of nursing care is a dynamic phenomenon and at the same time an important indicator both for the planning and management of human and material resources as well as the overall evaluation of the provided nursing care. In today's dynamically changing environment, the universal coverage of citizens' health needs and the rational distribution of available resources are basic conditions for the sustainability of health systems internationally. This in turn requires that hospital care reimbursement models, and DRGS in particular, reflect the holistic nature of hospital care provided, incorporating the multidimensional and complex role of nursing at all levels.