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Inpatient reimbursement system in Italy: How do tariffs relate to costs?

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  • Giovanni Fattore

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  • Aleksandra Torbica

Abstract

In 1995 the Italian National Health Service begun to fund its hospitals on a per case basis, classified according to a DRGs system. Five out of 21 Italian regions developed a regional DRG tariff system, while the majority adopted the system set at national level. The article presents how tariffs are set by the national government and by the Lombardy Region. Production cost (mainly assessed according to a top-down, gross-costing approach) is only one of the variables used for setting tariffs. Microcosting is not used and, apparently, is not deemed as an appropriate methodology. After 10 years since their introduction national and regional tariffs are still not derived from explicit algorithms. Copyright Springer Science + Business Media, LLC 2006

Suggested Citation

  • 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.
  • Handle: RePEc:kap:hcarem:v:9:y:2006:i:3:p:251-258
    DOI: 10.1007/s10729-006-9092-2
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    References listed on IDEAS

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    1. George France & Francesco Taroni & Andrea Donatini, 2005. "The Italian health-care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 187-202.
    2. Eugenio Anessi-Pessina & Elena Cantù & Claudio Joninii, 2004. "Phasing Out Market Mechanisms in the Italian National Health Service," Public Money & Management, Chartered Institute of Public Finance and Accountancy, vol. 24(5), pages 309-316, October.
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    Citations

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    Cited by:

    1. Lorenzo Cappellari & Anna De Paoli & Gilberto Turati, 2016. "Do market incentives for hospitals affect health and service utilization?: evidence from prospective pay system–diagnosis-related groups tariffs in Italian regions," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 179(4), pages 885-905, October.
    2. Finocchiaro Castro, Massimo & Guccio, Calogero & Pignataro, Giacomo & Rizzo, Ilde, 2014. "The effects of reimbursement mechanisms on medical technology diffusion in the hospital sector in the Italian NHS," Health Policy, Elsevier, vol. 115(2), pages 215-229.
    3. Fattore, Giovanni & Petrarca, Giuseppina & Torbica, Aleksandra, 2014. "Traveling for care: Inter-regional mobility for aortic valve substitution in Italy," Health Policy, Elsevier, vol. 117(1), pages 90-97.
    4. Lorenzo Cappellari & Anna De Paoli & Gilberto Turati, 2016. "Do Market Incentives for Hospitals Affect Health and Service Utilization? Evidence from PPS-DRG Tariffs in Italian Regions," CESifo Working Paper Series 5804, CESifo Group Munich.
    5. Cavalieri, M. & Guccio, C. & Lisi, D. & Pignataro, G., 2015. "Does the Extent of Per-Case Payment System Affect Hospital Efficiency? Evidence from the Italian NHS," Health, Econometrics and Data Group (HEDG) Working Papers 15/29, HEDG, c/o Department of Economics, University of York.
    6. Cappellaro, Giulia & Fattore, Giovanni & Torbica, Aleksandra, 2009. "Funding health technologies in decentralized systems: A comparison between Italy and Spain," Health Policy, Elsevier, vol. 92(2-3), pages 313-321, October.
    7. Jonas Schreyögg & Tom Stargardt & Oliver Tiemann & Reinhard Busse, 2006. "Methods to determine reimbursement rates for diagnosis related groups (DRG): A comparison of nine European countries," Health Care Management Science, Springer, vol. 9(3), pages 215-223, August.
    8. Shafik Hebous, 2014. "Money at the Docks of Tax Havens: A Guide," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 70(3), pages 458-485, September.
    9. Roberto Vona & Nadia Di Paola, 2014. "Lean thinking in sanità: il caso della logistica degli approvvigionamenti e della distribuzione ospedaliera dei farmaci," MECOSAN. Menagement e economia sanitaria, FrancoAngeli Editore, vol. 2014(91), pages 105-122.
    10. Francese, Maura & Piacenza, Massimiliano & Romanelli, Marzia & Turati, Gilberto, 2014. "Understanding inappropriateness in health spending: The role of regional policies and institutions in caesarean deliveries," Regional Science and Urban Economics, Elsevier, vol. 49(C), pages 262-277.
    11. Raulinajtys-Grzybek, Monika, 2014. "Cost accounting models used for price-setting of health services: An international review," Health Policy, Elsevier, vol. 118(3), pages 341-353.
    12. De Nicola, Arianna & Gitto, Simone & Mancuso, Paolo, 2011. "A two-stage DEA model to evaluate the efficiency of the Italian health system," MPRA Paper 39126, University Library of Munich, Germany.
    13. Polyzos, Nikolaos & Karanikas, Haralampos & Thireos, Eleftherios & Kastanioti, Catherine & Kontodimopoulos, Nick, 2013. "Reforming reimbursement of public hospitals in Greece during the economic crisis: Implementation of a DRG system," Health Policy, Elsevier, vol. 109(1), pages 14-22.

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