Table 5. Summary of the payment systems used in current Smart Hospitals with its key features, advantages and limitations.
The information presented in this table is derived from multiple sources [36-45].
Table Credits: Ehab Shabo
| Payment System | Key Points | Advantages | Challenges |
| DRG (Diagnosis-Related Groups) | Case-based, flat-rate payments based on diagnosis, severity, and treatment efforts | Provides predictable payments and encourages efficiency. | May undervalue complex or prolonged cases. |
| PAE (Per-Diem System) | Fixed rate per treatment day, commonly used in acute care settings. | Simple to administer, transparent for routine cases. | Does not reflect the actual treatment complexity or specific costs. |
| Case-Mix System | Payment calculated based on the complexity and mix of cases treated, ideal for specialized hospitals by considering differences in treating complex conditions. | Tailored for specialized care; accounts for case complexity. | Consistent application may be challenging due to varying case data and analysis requirements. |
| DRG - P4P (Pay for Performance) | An evolved DRG model that also rewards quality and efficiency by incorporating performance metrics (e.g., patient satisfaction, guideline adherence). | Incentivizes high-quality and efficient care. | Measuring quality consistently can be complex and may be prone to metric manipulation. |
| Global Budgets/Global Payment System | Lump-sum payment provided for all patients over a specific period or within a defined patient group | Encourages preventive care and long-term health outcomes; simplifies budgeting. | Risk of budget overruns if patient numbers or treatment complexity exceed initial estimates. |
| Fee-for-Service (FFS) | Payment is made for each individual service or treatment provided, ensuring each procedure is accounted for. | Reflects the actual cost of services provided; rewards each service rendered. | May incentivize over-treatment and increased service volume over quality care. |
| Health Outcome-Based Payment (HOBP) and Pay for Quality (P4Q) | Links payments directly to patient outcomes and treatment success, rather than solely to the number or cost of services rendered. | Rewards successful treatment outcomes and effective patient recovery. | Requires accurate, long-term outcome measurements which can be complex and resource-intensive. |