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Methods to determine reimbursement rates for diagnosis related groups (DRG): A comparison of nine European countries

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  • Jonas Schreyögg

    ()

  • Tom Stargardt
  • Oliver Tiemann
  • Reinhard Busse

Abstract

Over the past 20 years, most European countries have introduced DRGs or similar grouping systems as instruments for hospital reimbursement. This paper compares and analyzes the methods used to determine prices for inpatient care within DRGs or similar grouping systems employed in nine EU member states (i.e. Denmark, France, Germany, Hungary, Italy, the Netherlands, Poland, Spain and England). It categorizes the systems of patient classification used in these nine countries and compares them according to the three steps necessary in order to set prices: 1.) definition of a data sample, 2.) use of trimming methods and plausibility checks and 3.) definition of prices. It concludes with a discussion on the typical development path of DRG systems and the role of additional reimbursement components in this context. Copyright Springer Science + Business Media, LLC 2006

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Bibliographic Info

Article provided by Springer in its journal Health Care Management Science.

Volume (Year): 9 (2006)
Issue (Month): 3 (August)
Pages: 215-223

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Handle: RePEc:kap:hcarem:v:9:y:2006:i:3:p:215-223

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Web page: http://www.springerlink.com/link.asp?id=101767

Related research

Keywords: Hospital charges; Hospital costs; Hospital information systems; Financial management; Accounting; Diagnosis related groups; Prospective payment system;

References

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  1. Fernando Sánchez-Martínez & José-María Abellán-Perpiñán & Jorge-Eduardo Martínez-Pérez & Jaume Puig-Junoy, 2006. "Cost accounting and public reimbursement schemes in Spanish hospitals," Health Care Management Science, Springer, vol. 9(3), pages 225-232, August.
  2. David Epstein & Anne Mason, 2006. "Costs and prices for inpatient care in England: Mirror twins or distant cousins?," Health Care Management Science, Springer, vol. 9(3), pages 233-242, August.
  3. J. Schreyögg & T. Stargardt & M. Velasco-Garrido & R. Busse, 2005. "Defining the “Health Benefit Basket” in nine European countries," The European Journal of Health Economics, Springer, vol. 6(1), pages 2-10, November.
  4. Martine Bellanger & Laurent Tardif, 2006. "Accounting and reimbursement schemes for inpatient care in France," Health Care Management Science, Springer, vol. 9(3), pages 295-305, August.
  5. Peter Gaal & Nóra Stefka & Júlia Nagy, 2006. "Cost accounting methodologies in price setting of acute inpatient services in Hungary," Health Care Management Science, Springer, vol. 9(3), pages 243-250, August.
  6. Giovanni Fattore & Aleksandra Torbica, 2006. "Inpatient reimbursement system in Italy: How do tariffs relate to costs?," Health Care Management Science, Springer, vol. 9(3), pages 251-258, August.
  7. Jonas Schreyögg & Oliver Tiemann & Reinhard Busse, 2006. "Cost accounting to determine prices: How well do prices reflect costs in the German DRG-system?," Health Care Management Science, Springer, vol. 9(3), pages 269-279, August.
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Citations

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Cited by:
  1. Tom Stargardt, 2008. "Health service costs in Europe: cost and reimbursement of primary hip replacement in nine countries," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages S9-S20.
  2. Gartner, Daniel & Kolisch, Rainer, 2014. "Scheduling the hospital-wide flow of elective patients," European Journal of Operational Research, Elsevier, vol. 233(3), pages 689-699.
  3. Dirk Schürmann & Sonja Sorensen & Erwin Cock & Sandeep Duttagupta & Ansgar Resch, 2009. "Cost-effectiveness of linezolid versus vancomycin for hospitalised patients with complicated skin and soft-tissue infections in Germany," The European Journal of Health Economics, Springer, vol. 10(1), pages 65-79, February.
  4. Roll, Kathrin & Stargardt, Tom & Schreyögg, Jonas, 2011. "Effect of type of insurance and income on waiting time for outpatient care," hche Research Papers 2011/03, Hamburg Center for Health Economics (hche), University of Hamburg.
  5. Longo, R & Miraldo, M & Street, A, 2009. "Price regulation of pluralistic markets subject to provider collusion," Working Papers 1454, Imperial College, London, Imperial College Business School.
  6. Matthias Vogl, 2012. "Assessing DRG cost accounting with respect to resource allocation and tariff calculation: the case of Germany," Health Economics Review, Springer, vol. 2(1), pages 1-12, December.
  7. Michael Bäumler & Tom Stargardt & Jonas Schreyögg & Reinhard Busse, 2012. "Cost Effectiveness of Drug-Eluting Stents in Acute Myocardial Infarction Patients in Germany," Applied Health Economics and Health Policy, Springer, vol. 10(4), pages 235-248, July.
  8. Hamada, Hironori & Sekimoto, Miho & Imanaka, Yuichi, 2012. "Effects of the per diem prospective payment system with DRG-like grouping system (DPC/PDPS) on resource usage and healthcare quality in Japan," Health Policy, Elsevier, vol. 107(2), pages 194-201.
  9. Heimeshoff, Mareike & Schreyögg, Jonas, 2013. "Estimation of a physician practice cost function," hche Research Papers 2013/07, Hamburg Center for Health Economics (hche), University of Hamburg.
  10. Giovanni Fattore & Aleksandra Torbica, 2008. "Cost and reimbursement of cataract surgery in Europe: a cross-country comparison," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages S71-S82.
  11. Schreyögg, Jonas & Bäumler, Michael & Busse, Reinhard, 2009. "Balancing adoption and affordability of medical devices in Europe," Health Policy, Elsevier, vol. 92(2-3), pages 218-224, October.
  12. Sutherland, Jason Murray & Walker, Jan, 2008. "Challenges of rehabilitation case mix measurement in Ontario hospitals," Health Policy, Elsevier, vol. 85(3), pages 336-348, March.
  13. Machiel Westerdijk & Joost Zuurbier & Martijn Ludwig & Sarah Prins, 2012. "Defining care products to finance health care in the Netherlands," The European Journal of Health Economics, Springer, vol. 13(2), pages 203-221, April.
  14. Jonas Schreyögg & Oliver Tiemann & Tom Stargardt & Reinhard Busse, 2008. "Cross-country comparisons of costs: the use of episode-specific transitive purchasing power parities with standardised cost categories," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages S95-S103.
  15. Jonas Schreyögg, 2008. "A micro-costing approach to estimating hospital costs for appendectomy in a Cross-European context," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages S59-S69.
  16. Jérôme LARTIGAU, 2013. "Prospective Payment Systems And Evolution Of Management Control In French Hospitals: An Overview," Scientific Bulletin - Economic Sciences, University of Pitesti, vol. 12(2), pages 24-39.
  17. Stefan Felder, 2009. "The variance of length of stay and the optimal DRG outlier payments," International Journal of Health Care Finance and Economics, Springer, vol. 9(3), pages 279-289, September.
  18. Andrew Street & Kirsi Vitikainen & Afsaneh Bjorvatn & Anne Hvenegaard, 2007. "Introducing activity-based financing: a review of experience in Australia, Denmark, Norway and Sweden," Working Papers 030cherp, Centre for Health Economics, University of York.
  19. Siok Tan & Leona Hakkaart-van Roijen & B. Ineveld & W. Redekop, 2013. "Explaining length of stay variation of episodes of care in the Netherlands," The European Journal of Health Economics, Springer, vol. 14(6), pages 919-927, December.
  20. Vogl, Matthias, 2014. "Hospital financing: Calculating inpatient capital costs in Germany with a comparative view on operating costs and the English costing scheme," Health Policy, Elsevier, vol. 115(2), pages 141-151.
  21. Oliver Tiemann, 2008. "Variations in hospitalisation costs for acute myocardial infarction - a comparison across Europe," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages S33-S45.
  22. Giovanni Iuzzolino, 2008. "Demand and supply of hospital services. International trends," Questioni di Economia e Finanza (Occasional Papers) 27, Bank of Italy, Economic Research and International Relations Area.

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