Evaluating the Development and Implementation of Cost Centres, Functional Business Units and Diagnosis-Related Groups in South African Hospitals since 2010: A Scoping Review Protocol

Abstract Objective: The objective of this scoping review is to assess the extent of the literature on the development and implementation of cost centres, functional business units (FBUs), and diagnosis-related groups (DRGs) in South African hospitals since 2010. The review aims to map existing evidence on these financial management mechanisms and their role in improving healthcare efficiency under the National Health Insurance (NHI) framework. Introduction: Financial management remains a critical challenge in South Africa’s healthcare system, contributing to resource misallocation and suboptimal service delivery. Cost centres, FBUs, and DRGs have been proposed as mechanisms to enhance financial accountability and resource allocation in hospitals within the NHI. While international models have demonstrated the effectiveness of these approaches, limited research has examined their development and implementation in South Africa, necessitating a comprehensive review of current financial structures within the healthcare system. Inclusion Criteria: This review will include studies from 2010, that focus on public and private hospitals in South Africa, examining cost centre management, FBUs, and DRG-based financing. Studies that focus on other financial models, non-hospital healthcare facilities, or are published before 2010 will be excluded. Methodology: The review will follow JBI scoping review methodology. A comprehensive search will be conducted across databases such as PubMed, SAMJ, MEDLINE, CINAHL, Web of Science Core Collection, Google Scholar, and WorldCat, including grey literature sources. Independent reviewers will screen, select, and extract data from studies using a standardised tool. Findings will be synthesised and presented in a narrative summary with tabular and graphical representations to identify trends, gaps, and implications for policy and practice.