IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v119y2015i3p252-257.html
   My bibliography  Save this article

Policy trends and reforms in the German DRG-based hospital payment system

Author

Listed:
  • Klein-Hitpaß, Uwe
  • Scheller-Kreinsen, David

Abstract

A central structural point in all DRG-based hospital payment systems is the conversion of relative weights into actual payments. In this context policy makers need to address (amongst other things) (a) how the price level of DRG-payments from one period to the following period is changed and (b) whether and how hospital payments based on DRGs are to be differentiated beyond patient characteristics, e.g. by organizational, regional or state-level factors. Both policy problems can be and in international comparison often are empirically addressed. In Germany relative weights are derived from a highly sophisticated empirical cost calculation, whereas the annual changes of DRG-based payments (base rates) as well as the differentiation of DRG-based hospital payments beyond patient characteristics are not empirically addressed. Rather a complex set of regulations and quasi-market negotiations are applied. There were over the last decade also timid attempts to foster the use of empirical data to address these points. However, these reforms failed to increase the fairness, transparency and rationality of the mechanism to convert relative weights into actual DRG-based hospital payments.

Suggested Citation

  • Klein-Hitpaß, Uwe & Scheller-Kreinsen, David, 2015. "Policy trends and reforms in the German DRG-based hospital payment system," Health Policy, Elsevier, vol. 119(3), pages 252-257.
  • Handle: RePEc:eee:hepoli:v:119:y:2015:i:3:p:252-257
    DOI: 10.1016/j.healthpol.2015.01.006
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851015000093
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.healthpol.2015.01.006?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Ankit Kumar & Michael Schoenstein, 2013. "Managing Hospital Volumes: Germany and Experiences from OECD Countries," OECD Health Working Papers 64, OECD Publishing.
    2. Conrad Kobel & Josselin Thuilliez & Martine Bellanger & Karl-Peter Pfeiffer, 2011. "DRG systems and similar patient classification systems in Europe," Université Paris1 Panthéon-Sorbonne (Post-Print and Working Papers) halshs-00643049, HAL.
    3. Anne Mason & Marisa Miraldo & Luigi Siciliani & Peter Sivey & Andrew Street, 2008. "Establishing a Fair Playing Field for Payment by Results," Working Papers 039cherp, Centre for Health Economics, University of York.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Caryn Bredenkamp & Sarah Bales & Kristiina Kahur, 2020. "Transition to Diagnosis-Related Group Payments for Health," World Bank Publications - Books, The World Bank Group, number 33034, December.
    2. Francesco Longo & Luigi Siciliani & Andrew Street, 2019. "Are cost differences between specialist and general hospitals compensated by the prospective payment system?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 7-26, February.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Nils Gutacker & Andrew Street, 2018. "Multidimensional performance assessment of public sector organisations using dominance criteria," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 13-27, February.
    2. Silvia Angerer & Klaus Buttinger & Harald Stummer, 2019. "The weekend effect revisited: evidence from the Upper Austrian stroke registry," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(5), pages 729-737, July.
    3. Jackson, Terri & Dimitropoulos, Vera & Madden, Richard & Gillett, Steve, 2015. "Australian diagnosis related groups: Drivers of complexity adjustment," Health Policy, Elsevier, vol. 119(11), pages 1433-1441.
    4. Karen S Palmer & Thomas Agoritsas & Danielle Martin & Taryn Scott & Sohail M Mulla & Ashley P Miller & Arnav Agarwal & Andrew Bresnahan & Afeez Abiola Hazzan & Rebecca A Jeffery & Arnaud Merglen & Ahm, 2014. "Activity-Based Funding of Hospitals and Its Impact on Mortality, Readmission, Discharge Destination, Severity of Illness, and Volume of Care: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-1, October.
    5. Cooper, Zack & Gibbons, Stephen & Skellern, Matthew, 2018. "Does competition from private surgical centres improve public hospitals' performance? Evidence from the English National Health Service," Journal of Public Economics, Elsevier, vol. 166(C), pages 63-80.
    6. Chanturidze, Tata & Esau, Mike & Hölzer, Simon & Richardson, Erica, 2016. "Introducing Diagnosis-Related Groups in Kazakhstan: Evolution, achievements, and challenges," Health Policy, Elsevier, vol. 120(9), pages 987-991.
    7. Natalie Baier & Lisa-Marie Sax & Leonie Sundmacher, 2019. "Trends and regional variation in rates of orthopaedic surgery in Germany: the impact of competition," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 163-174, February.
    8. Bofinger, Peter & Feld, Lars P. & Schmidt, Christoph M. & Schnabel, Isabel & Wieland, Volker, 2018. "Vor wichtigen wirtschaftspolitischen Weichenstellungen. Jahresgutachten 2018/19," Annual Economic Reports / Jahresgutachten, German Council of Economic Experts / Sachverständigenrat zur Begutachtung der gesamtwirtschaftlichen Entwicklung, volume 127, number 201819.
    9. Medin, Emma & Häkkinen, Unto & Linna, Miika & Anthun, Kjartan S. & Kittelsen, Sverre A.C. & Rehnberg, Clas, 2013. "International hospital productivity comparison: Experiences from the Nordic countries," Health Policy, Elsevier, vol. 112(1), pages 80-87.
    10. Corinna Hentschker & Roman Mennicken, 2015. "The Volume‐Outcome Relationship and Minimum Volume Standards – Empirical Evidence for Germany," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 644-658, June.
    11. Nico Pestel & Florian Wozny, 2019. "Low Emission Zones for Better Health: Evidence from German Hospitals," CINCH Working Paper Series 1904, Universitaet Duisburg-Essen, Competent in Competition and Health.
    12. Alexander Geissler & David Scheller‐Kreinsen & Wilm Quentin & on behalf of the EuroDRG group, 2012. "Do Diagnosis‐Related Groups Appropriately Explain Variations In Costs And Length Of Stay Of Hip Replacement? A Comparative Assessment Of Drg Systems Across 10 European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 103-115, August.
    13. Andrew Street & Conrad Kobel & Thomas Renaud & Josselin Thuilliez & ON BEHALF OF THE EURODRG GROUP, 2012. "How Well Do Diagnosis‐Related Groups Explain Variations In Costs Or Length Of Stay Among Patients And Across Hospitals? Methods For Analysing Routine Patient Data," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 6-18, August.
    14. Conrad Kobel & Engelbert Theurl, 2013. "Hospital specialisation within a DRG-Framework: The Austrian Case," Working Papers 2013-06, Faculty of Economics and Statistics, University of Innsbruck.
    15. Jacobs, Rowena & Chalkley, Martin & Böhnke, Jan R. & Clark, Michael & Moran, Valerie & Aragón, M. J., 2019. "Measuring the activity of mental health services in England: variation in categorising activity for payment purposes," LSE Research Online Documents on Economics 101333, London School of Economics and Political Science, LSE Library.
    16. Hentschker, Corinna & Wübker, Ansgar, 2020. "Quasi-experimental evidence on the effectiveness of heart attack treatment in Germany," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, pages 1-15.
    17. Unto Häkkinen & Gunnar Rosenqvist & Tor Iversen & Clas Rehnberg & Timo T. Seppälä & on behalf of the EuroHOPE study group, 2015. "Outcome, Use of Resources and Their Relationship in the Treatment of AMI, Stroke and Hip Fracture at European Hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 116-139, December.
    18. Reinhard Busse & on behalf of the EuroDRG group, 2012. "DO DIAGNOSIS‐RELATED GROUPS EXPLAIN VARIATIONS IN HOSPITAL COSTS AND LENGTH OF STAY? – ANALYSES FROM THE EURODRG PROJECT FOR 10 EPISODES OF CARE ACROSS 10 EuroPEAN COUNTRIES," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 1-5, August.
    19. Petrou, Panagiotis & Vandoros, Sotiris, 2018. "Healthcare reforms in Cyprus 2013–2017: Does the crisis mark the end of the healthcare sector as we know it?," Health Policy, Elsevier, vol. 122(2), pages 75-80.
    20. Stefan Meyer, 2015. "Payment schemes and cost efficiency: evidence from Swiss public hospitals," International Journal of Health Economics and Management, Springer, vol. 15(1), pages 73-97, March.

    More about this item

    Keywords

    Hospital; Price; Germany; Reform; Baserate; DRG;
    All these keywords.

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:119:y:2015:i:3:p:252-257. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: http://www.elsevier.com/locate/healthpol .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.