„Diagnosis Related Groups“ (DRG) und kosteneffiziente Steuerungssysteme im Krankenhaus

Summary Most German hospitals are part of a health care system regulated by state agencies. Nevertheless, cost awareness and cost behaviour of physicians and hospital managers are influenced by market pressure whose impact depends on the structure of the payment system. The article investigates rationalization and margin effects by referring to the concept of the adequate plan of medical treatment. These effects are induced by the introduction of the concept of Diagnosis Related Groups (DRG), a case-based financing mechanism. Using a typology of alternative forms of payment which offers new insights into the economic incentives of hospital funding it is shown that fixed-fee DRG payments increase the pressure on costs. The tendencies in hospitals to control patient care costs through the adoption of more efficient control techniques, such as those commonly employed by manufacturing firms, are critically surveyed.