OBJECTIVES : DRG-based payment system was implemented in Russia in 2013 and is used presently by vast majority of subjects of Russian Federation. Introduction of DRG-based payment often leads to decrease of length of stay (LoS) at hospitals. Still there is a risk of increasing rate of more expensive cases hospitalization. This study assessed the general trends in average LoS as well as average DRG relative weight (ARW) at Russian hospitals in 2016-2018.

METHODS : Data on the medical care payment (inpatient medical care and some kinds of day care payed by DRG in Russia) for 2016-2018 was analyzed. Regions not applying federal DRG system or having incorrect or incomplete data were excluded from the analysis. The analysis of LoS and ARW was conducted in the context of system as a whole.

RESULTS : There was a systematic decrease in LoS for inpatient care by 1.4-1.56% per year (from 9.11 to 8.85 days). LoS for day care payed by DRG slightly declined by less than 1% in 2 years (from 9.49 to 9.40 days). ARW increased both in inpatient and day care. The growth of indicator in inpatient care was systematic – from 1.13 in 2016 to 1.16 in 2017 and 1.17 in 2018. What concerns outpatient care there was an increase in 2017 by 8.7% (from 1.24 to 1.35) and then in 2018 ARW decreased by 1.1% reaching the level of 1.33.

CONCLUSIONS : Both in inpatient and day medical care payed by DRG the LoS is reduced, which corresponds to the global trends and tasks of DRG system implementation. At the same time the trend in ARW deserves special attention because of significant excess of the value over 1, especially in day care. This should be taken into account while revising DRG relative weights in order to maintain financial balance.