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A new case-mix based payment system for the psychiatric day care sector in Switzerland: proposed methods for developing the tariff structure

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  • Noll, Samuel
  • Haag, Sarah
  • Guidon, Rémi
  • Hölzer, Simon

Abstract

In many European countries, there has been a shift towards outpatient psychiatric care over the past decades, as it is more cost-effective and resources for health care are limited. Switzerland, however, still has a high number of inpatient psychiatric hospital beds and a comparatively high length of stay. The existence of differing remuneration systems between inpatient and outpatient settings creates a distortion of incentives regarding the choice of treatment setting and an inefficient allocation of resources. To address this issue, a new tariff structure for day care treatment is suggested, based on the development and evaluation of the DRG-based inpatient remuneration system tariff psychiatry (TARPSY), using inpatient data from 2018, 2019, and 2021. The method involves three steps: estimating the day care treatment setting potential by delimiting cases from the inpatient patient data, adjusting the costs of this subset to approximate a day care treatment setting, and calculating daily cost weights based on the existing cost weights. The resulting reimbursements are about half of the inpatient reimbursements.

Suggested Citation

  • Noll, Samuel & Haag, Sarah & Guidon, Rémi & Hölzer, Simon, 2023. "A new case-mix based payment system for the psychiatric day care sector in Switzerland: proposed methods for developing the tariff structure," Health Policy, Elsevier, vol. 131(C).
    • Handle: RePEc:eee:hepoli:v:131:y:2023:i:c:s0168851023000829
    DOI: 10.1016/j.healthpol.2023.104797
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