Introduction of diagnosis-related groups in Germany: evaluation of impact on in-patient care in a dermatological setting

Hensen, Peter; Beissert, Stefan; Bruckner‐Tuderman, Leena; Luger, T A; Roeder, N.; Müller, Marcel Lucas

doi:10.1093/eurpub/ckm059

Cited by 22 publications

(28 citation statements)

References 19 publications

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“…We also found new studies reporting the effects of DRG payment after the year of 2000 in Asian countries [21,[23][24][25], European countries [26][27][28][29][30][31], and for international comparisons [8,9]. These studies yielded similar findings to those conducted in the United States.…”

Section: Previous Studies Evaluating Drg Paymentsupporting

confidence: 67%

The impacts of DRG-based payments on health care provider behaviors under a universal coverage system: A population-based study

2012

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Section: Previous Studies Evaluating Drg Paymentsupporting

confidence: 67%

The impacts of DRG-based payments on health care provider behaviors under a universal coverage system: A population-based study

2012

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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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“…In December 1999 the federal German government announced the introduction of a prospective payment system based on diagnosis related groups (DRG) in 2004 as an attempt to increase the hospital efficiency (e.g. [19,32]). Under DRG based financing hospitals receive a fixed rate for each admission depending on a patient's diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“…Evidence for such behavioral adjustments of hospitals is given for dermatological hospital admissions by Hensen et al [19]. Furthermore, Böcking et al [8] mention that hospitals preferably treat cases with high reimbursement rates and a low level of complexity.…”

Section: Introductionmentioning

confidence: 99%

On the effect of prospective payment on local hospital competition in Germany

Herwartz

Strumann

2011

Health Care Manag Sci

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The introduction of prospective hospital reimbursement based on diagnosis related groups (DRG) in 2004 has been a conspicuous attempt to increase hospital efficiency in the German health sector. As a consequence of the reform a rise of competition for (low cost) patients could be expected. In this paper the competition between hospitals, quantified as spatial spillover estimates of hospital efficiency, is analyzed for periods before and after the reform. We implement a two-stage efficiency model that allows for spatial interdependence among hospitals. Hospital efficiency is determined by means of non-parametric and parametric econometric frontier models. We diagnose a significant increase of negative spatial spillovers characterizing hospital performance in Germany, and thus, confirm the expected rise of competition.

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Introduction of diagnosis-related groups in Germany: evaluation of impact on in-patient care in a dermatological setting

Cited by 22 publications

References 19 publications

The impacts of DRG-based payments on health care provider behaviors under a universal coverage system: A population-based study

The impacts of DRG-based payments on health care provider behaviors under a universal coverage system: A population-based study

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

On the effect of prospective payment on local hospital competition in Germany

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