First results of the introduction of DRGs in Germany and overview of experience from other DRG countries

Böcking, Wolfgang; Ahrens, Ulrich; Kirch, Wilhelm; Milaković, Mishael

doi:10.1007/s10389-005-0103-4

Cited by 41 publications

(43 citation statements)

References 25 publications

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“…By moving to paying a benchmark "price" for diagnostically similar services, more efficient hospitals stand to financially benefit while less efficient hospitals will face economic pressures to improve efficiency. This has been demonstrated to help reduce costs and average lengths of stay across several OECD countries (Böcking, et al, 2005). Early evidence from the introduction of DRG-based payments in some Swiss cantons suggests it can deliver a relocation of resources to outpatient care (Busato and Below, 2010).…”

Section: Hospital Financingmentioning

confidence: 99%

“…For this reason, best practice models of introducing DRGs across OECD countries have incorporated explicit strategies for dealing with the potential for an increase in volumes and admissions. For example, when first implementing DRGs for Medicare, the United States initially introduced surveillance and warnings to impose sanctions if the number of admissions was to increase dramatically (Böcking et al, 2005). In France, DRG tariffs are adjusted downwards if the health insurance spending target for hospital care is exceeded (Ministère de la Santé et des Sports, 2010).…”

Section: … But the Way Drgs Are Implemented Will Influence The Extentmentioning

confidence: 99%

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Individual Responsibility and Community Solidarity — The Swiss Health Care System

Biller‐Andorno

Zeltner

2015

N Engl J Med

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Section: Hospital Financingmentioning

confidence: 99%

Section: … But the Way Drgs Are Implemented Will Influence The Extentmentioning

confidence: 99%

Individual Responsibility and Community Solidarity — The Swiss Health Care System

Biller‐Andorno

Zeltner

2015

N Engl J Med

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“…a Results also reported in Farrar et al (2007). England (Farrar et al, 2007Audit Commission, 2008b), France (Ministry of Health, 2009 and Germany (Bö cking et al, 2005;Hensen et al, 2008). As noted above, though, factors other than the introduction of activity-based funding may have affected this outcome.…”

Section: Impactmentioning

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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“…All inpatient healthcare providers are forced to deal with such a new payment system. Since this time, a change in coding quality could be observed [11]. A further limitation follows from the reduced cost coverage.…”

Section: Discussionmentioning

confidence: 99%

Cost-Benefit Assessment of Antifungal Prophylaxis with Liposomal Amphotericin B in Neutropenic Patients

Penack

Reinhold²,

Thiel³

et al. 2007

Oncol Res Treat

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Background: In a recently reported randomized trial, lowdose intravenous liposomal amphotericin B (L-AmB) reduced the incidence of invasive fungal infections (20.2 vs. 4.6%, p < 0.001) in high-risk patients with hematological malignancies and prolonged neutropenia. Patients and Methods: In the present study, we performed a retrospective cost-benefit analysis of L-AmB prophylaxis from the hospital perspective. Results: Ninety-nine patients were eligible; baseline characteristics were balanced for age, sex, underlying disease, and duration of neutropenia. The mean duration of hospitalization was 42.9 days and 52.3 days in the prophylaxis arm and in patients without antifungal prophylaxis, respectively (p = 0.096). The L-AmB prophylaxis was associated with additional costs of approximately EUR 630 per patient. However, total medication costs (including L-AmB prophylaxis) were EUR 1,219 and EUR 2,815 in patients with L-AmB prophylaxis and in patients in the control arm, respectively (p < 0.001). When involving also costs for medical procedures, the L-AmB prophylaxis reaches a positive net benefit of EUR 1,094 per patient. Conclusions: Our data shows that antifungal prophylaxis, e.g. with L-AmB, can be a safe and effective strategy to reduce the frequency of invasive fungal infections in selected high-risk patients and to obtain significant cost savings for the hospital. Cost-Benefit Assessment of Antifungal Prophylaxis with Liposomal Amphotericin B in Neutropenic Patients Olaf Penacka Thomas Reinholdb Eckhard Thiela Igor Wolfgang Blaua a Department of Hematology, Oncology, and Transfusion Medicine, Charité Campus Benjamin Franklin, bInstitute for Social Medicine, Epidemiology and Health Economics, Charité Campus Mitte, Berlin, Germany

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First results of the introduction of DRGs in Germany and overview of experience from other DRG countries

Abstract: In spite of numerous discussions and programs aimed at reducing public health care costs in Germany, the country has seen a massive increase in health care costs at an annual average rate of 7% since 1972. When

Cited by 41 publications

References 25 publications

Individual Responsibility and Community Solidarity — The Swiss Health Care System

Individual Responsibility and Community Solidarity — The Swiss Health Care System

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

Cost-Benefit Assessment of Antifungal Prophylaxis with Liposomal Amphotericin B in Neutropenic Patients

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