Authors: Yana Kashilksa, Atanas Petkov, Atanas Batashki
Keywords: clinical paths, case mix, diagnostically related groups

It is useful to know the experience of Bulgaria in terms of case-mix and DRG in view of guidelines for possible future activities on pilot implementation of DRG for a new payment and budgeting system. Since the mid-1990s, DRG research has been conducted in the country and a number of projects have been implemented.
At the end of 1993 Robert Fetter, one of the people who developed DRGs in the United States, was invited to Bulgaria. He was the first to present to experts from the Bulgarian health institutions the main provisions of the case-mix approach and DRG.
The overview of the current state of the information systems for health management, information technologies and the infrastructure for the management of the information systems of the hospitals, as well
as the information systems of NCPHA, NHIF and MH, regarding the implementation of DRG, show the following: coding of clinical morbidity; - the current state of the IT infrastructure and systems of the ISMS, the hospitals, the NHIF, the NHIF and the Ministry of Health, as well as their capacity to implement DRGs.
There are two issues that need to be addressed before implementing a DRG-based payment system: - procedures and diagnoses in hospital systems and XML files should be encoded with AKMP 7.0 to eliminate the need to use mapping tables .; - special processing of the lists of diagnoses when exporting codes to the DRG group and removal of unusual coding rules for CP during the annual CP update.
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