The Diagnosis Related Group (DRG) model in hospitals is mainly used for increasing transparency in service provision and efficient use of resources, consequently leading to high level of quality of care. Countries define the scope and the price of the health services on a national level based upon determination of the “weight” for all DRG coded health services.

OBJECTIVES: Of this research is to present possible restructuring of gynecology-obstetric services on a national level using the existing DRG model in place, focused on deliveries as a benchmark for service provision.

MATERIALS: We used is the national Health Insurance Fund DRG database, populated online by medical professionals. Data was retrieved retrospectively for the period 2015-2019, with focus on 2018 as mid-point year.

METHODS: Statistical methods were used to describe the structure of the gynecology-obstetric and delivery services as per the DRG model.

RESULTS: Showed poor utilization of delivery services generally. Transfers to other health facilities (about 18%) and transfers towards tertiary health care (about 22%) showed inefficiency of hospitals to cope with the demand for provision of deliveries. University clinic as tertiary level of care hospital has 60% transfers from other hospitals.

CONCLUSIONS: Simulation model presents possible restructuring of services and shows improved hospitals’ efficiency. Re-distribution of cases should optimize provision of services and reduce transfers. Other measures for improving efficiency include better organization of medical teams, downsizing of inefficient health facilities, value-added use of financial resources and defined rules for managing patients at different levels of care. The model for restructuring can be used as a basis for additional analysis of other hospital segments where restructuring of services might be deemed needed. Enhanced model can be used for benchmarking with other countries and comparison between structure and organization of the services at national versus regional level.