International Review of Diagnosis-Related Group M&E Systems

As Vietnam reforms the social health insurance fund’s provider payment mechanism—shifting from a fee-for-service system to diagnosis-related group (DRG) payments for acute inpatient care—it is important that its monitoring and evaluation (M&E) framework meets the diverse needs of the different stakeholders involved, including: appropriate indicators to guide design of the DRG policy, supervise and inform DRG implementation, monitor hospital performance, and mitigate provider behaviors that might potentially be adverse. To inform the development of the DRG M&E framework, this report provides a review of international experience to draw out practical and scientific approaches for both the Ministry of Health (MOH) and Vietnam Social Security (VSS) to consider. Conclusions and recommendations are provided.