Implementing Diagnosis-Related Groups for Value-Based Healthcare in Saudi Arabia: A Systematic Review of Evidence on Barriers and Facilitators.

OBJECTIVE

To examine the barriers and facilitators to implementing Diagnosis-related groups (DRGs) in Kingdom of Saudi Arabia, aiming to identify actionable insights for policymakers and stakeholders to advance value-based healthcare (VBHC) adoption effectively.

METHODS

A systematic search of bibliographic databases and relevant grey literature was conducted. Data were synthesized using the Consolidated Framework for Implementation Research (CFIR) to categorize barriers and facilitators across 5 domains.

RESULTS

A total of 10 studies met the eligibility criteria. Key facilitators included the adoption of patient classification systems, standardized data sets, government policy support, and the availability of advanced health information systems. Barriers included incomplete clinical documentation, coding errors, inadequate training, and a lack of localized cost weights for Australian Refined DRG (AR-DRG) AR-DRG implementation. Gaps in clinician and coder awareness further hindered implementation.

CONCLUSION

While DRGs hold promise for achieving VBHC goals in Kingdom of Saudi Arabia, their successful implementation requires addressing technical, organizational, and cultural barriers. Policymakers should prioritize improving clinical documentation, training healthcare professionals, and localizing DRG systems to the Saudi healthcare context. These actions will help pave the way for an effective and sustainable transformation to VBHC in the country.