Comparison of cost accounting methods from different DRG systems and their effect on health care quality

Leister, Jan Eric; Stausberg, Jürgen

doi:10.1016/j.healthpol.2004.12.001

Cited by 32 publications

(27 citation statements)

References 11 publications

(22 reference statements)

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“…The bottom-up approach, as used in Germany and Finland, is essentially based on patient-level data on resource utilisation to which unit cost data are applied . Patient-level costing is considered more accurate because it is based on actual, rather than average, resource utilisation (Leister and Stausberg, 2005;. In the absence of patient-level (5) 125 (6) 39 (100) Inclusion of capital costs…”

Section: Hospital Costmentioning

confidence: 99%

Paying for hospital care: the experience with implementing activity-based funding in five European countries

O’Reilly

Busse²,

Häkkinen

et al. 2012

HEPL

105

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: Following the US experience, activity-based funding has become the most common mechanism for reimbursing hospitals in Europe. Focusing on five European countries (England, Finland, France, Germany and Ireland), this paper reviews the motivation for introducing activity-based funding, together with the empirical evidence available to assess the impact of implementation. Despite differences in the prevailing approaches to reimbursement, the five countries shared several common objectives, albeit with different emphasis, in moving to activity-based funding during the 1990s and 2000s. These include increasing efficiency, improving quality of care and enhancing transparency. There is substantial cross-country variation in how activity-based funding has been implemented and developed. In Finland and Ireland, for instance, activity-based funding is principally used to determine hospital budgets, whereas the models adopted in the other three countries are more similar to the US approach. Assessing the impact of activity-based funding is complicated by a shortage of rigorous empirical evaluations. What evidence is currently available, though, suggests that the introduction of activity-based funding has been associated with an increase in activity, a decline in length of stay and/or a reduction in the rate of growth in hospital expenditure in most of the countries under consideration.

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Section: Hospital Costmentioning

confidence: 99%

Paying for hospital care: the experience with implementing activity-based funding in five European countries

O’Reilly

Busse²,

Häkkinen

et al. 2012

HEPL

105

View full text Add to dashboard Cite

show abstract

“…The allocation was performed partly on the basis of allocation statistics, partly on the basis of billing data (hospital charges to patients or insurance companies) [17]. However, this costing method has been criticized for being too inexact, because charge data does not sufficiently reflect costs [18,19]. More recent examples of case-mix costing e.g., costing of the Australian DRG-system (AR-DRG) are based on the so-called bottom up approach [18,20] where the costs of individual patients are aggregated and assigned to the patient groups defined.…”

Section: Costing Methodologiesmentioning

confidence: 99%

Variable prospective financing in the Danish hospital sector and the development of a Danish case-mix system

Ankjaer-Jensen¹,

Rosling²,

Bilde³

2006

Health Care Manage Sci

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This article aims to describe and assess the Danish case-mix system, the cost accounting applied in setting national tariffs and the introduction of variable, prospective payment in the Danish hospital sector. The tariffs are calculated as a national average from hospital data gathered in a national cost database. However, uncertainty, mainly resulting from the definition of cost centres at the individual hospital, implies that the cost weights may not fully reflect the hospital treatment cost. As variable prospective payment of hospitals currently only applies to 20% of a hospital's budget, the incentives and the effects on productivity, quality and equality are still limited.

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“…Differing methods for analyzing such patients has been an issue in Belgium as well as other countries. 9 Swedish researchers have noted that improving overall health quality is also a component of DRG systems, 10 thus the issue of equity becomes important in any system of prospective payment for institutional care.…”

Section: International Comparisonsmentioning

confidence: 99%

A Global Perspective on Managed Care and Pharmacy Education

Fincham¹

2006

Am J Pharm Educ

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Comparison of cost accounting methods from different DRG systems and their effect on health care quality

Cited by 32 publications

References 11 publications

Paying for hospital care: the experience with implementing activity-based funding in five European countries

Paying for hospital care: the experience with implementing activity-based funding in five European countries

Variable prospective financing in the Danish hospital sector and the development of a Danish case-mix system

A Global Perspective on Managed Care and Pharmacy Education

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