The Path for Introducing Diagnosis Related Groups (DRGs) in Albanian Health care

Diagnosis Related Groups (DRGs) are the most used payment system in health care and the best way of introducing efficiency and effectiveness in its management. For this reason, they are particularly needed for transition countries which have to improve the quality and the quantity of the services delivered to customers. Albania especially is currently living in a period of deep innovation. The consolidation of its democracy, the increasing wealth of the population and the growth of the social needs require a new management approach for public administration and the construction of a more compliant model with the EU standards. This transformation also deeply involves the healthcare sector, which is actually redefining the financing, information system and accountability. For these reasons Albania could be a relevant case study in order to observe, starting from the first steps, the path for introducing a DRG payment system in modern health care. Using the case study method, this paper analyses the background, the governance and the financing of Albanian health care, focusing on the actual reform strategies. The results of the research have been the basis for defining the “National Guidelines of Quality Standards for Introduction of DRGs-based Payment”, adopted by the Albanian Ministry of Health (in 2017 became Ministry of Health and Social Protection), which represents an early roadmap for the introduction of DRGs and its future implementation to the whole of Albanian health care.