Objective: This study aims to investigate whether specific treatments or combinations of treatments are significantly associated with the profitability of Swiss acute-care hospitals under the current diagnosis-related group (S-DRG) reimbursement system, while accounting for differences between...

Background Hospital services are typically reimbursed using case-mix tools that group patients according to diagnoses and procedures. We recently developed a case-mix tool (i.e., the Queralt system) aimed at supporting clinicians in patient management. In this study, we compared the performance...

Per Ende 2023 wurden dem Bundesrat die beiden Vorschläge neuer Tarifsysteme für ambulant-medizinische Leistungen zur Genehmigung vorgelegt, welche den in die Jahre gekommenen TARMED ersetzen sollen. Ziel des vorliegenden Berichts ist es, die Vorzüge von ambulanten Pauschalen zu identifizieren...

Hospitals account for 40 % of all healthcare expenditures and play a central role in healthcare provision. Therefore, the way hospitals are payed has major implications for the care they provide. Yet the knowledge about system wide effects of payment reforms is surprisingly thin. This study...

This book examines how nine different health systems--U.S. Medicare, Australia, Thailand, Kyrgyz Republic, Germany, Estonia, Croatia, China (Beijing) and the Russian Federation--have transitioned to using case-based payments, and especially diagnosis-related groups (DRGs), as part of their...

Die Finanzierung der allgemeinen Krankenhäuser wurde vor mehr als 15 Jahren auf DRG-Fallpauschalen umgestellt (DRG: Diagnosis Related Groups). Ab dem Jahr 2003 konnten Krankenhäuser die neuen Fallpauschalen zunächst freiwillig anwenden, ab 2004 war die Abrechnung mit Fallpauschalen...

Many OECD countries have replaced per-diem hospital reimbursement with lump sum payments by diagnosis-related groups (DRGs). However, modern DRG systems still allow hospitals to pass on actual treatment costs to payers, which might hinder the efficiency of health care provision. This paper...