Background While COVID-19 hospitalization costs are essential for policymakers to make informed health care resource decisions, little is known about these costs in western Europe. The aim of the current study is to analyze these costs for a German setting, track the development of these costs...

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...

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...

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...

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...

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...

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...

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...

Um sowohl eine qualitativ hochwertige Versorgung anbieten zu können als auch aus wirtschaftlicher Sicht dauerhaft die eigene Existenz zu sichern, hat die Kosten- und Leistungsrechnung als Grundlage des Controllings eine herausragende Relevanz für die Krankenhäuser. Denn nur wer Kosten sowie...

We provide a political economy interpretation of the variations in the prices of 6 obstetric diagnosis-related groups (DRGs) using Italy as a case study. Italy provides a unique institutional setting since its 21 regional governments can decide to adopt the national DRG system or to adjust/waive...

Birth weight manipulation is common in per-case hospital reimbursement systems, in which hospitals receive more money for otherwise equal newborns with birth weight just below compared to just above specific birth weight thresholds. As hospitals receive more money for cases with weight below the...

Birth weight manipulation is common in per-case hospital reimbursement systems, in which hospitals receive more money for otherwise equal newborns with birth weight just below compared to just above specific birth weight thresholds. As hospitals receive more money for cases with weight below the...

Dieses Gutachten untersucht den Zusammenhang von Mengen‐ und Kostenveränderungen in der stationären Krankenhausversorgung. Ziel ist die Bestimmung des Fixkostenanteils an den Fallpauschalen (G‐DRG) für zusätzliche Leistungen. Für diese Fragestellung wird ein empirischer Ansatz auf...

Das Entlassungsmanagement zur Unterstützung einer sektorenübergreifenden Versorgung ist inzwischen eine gesetzlich vorgegebene Pflichtaufgabe der Krankenhäuser. Angesichts immer kürzerer Verweilzeiten und einer wachsenden Zahl chronisch kranker Patienten mit poststationärem...

This paper examines the behaviour of public hospitals in response to the average payment incentives created by price changes for patients classified in different Diagnosis Related Groups (DRGs). Using panel data on public hospitals located within the Italian region of Emilia-Romagna, we test...

Prospective payment arrangements are now the main form of hospital funding in most developed countries. An essential component of such arrangements is the classification system used to differentiate patients according to their expected resource requirements. In this article we describe the...

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...

Since 2003 German hospitals are reimbursed according to diagnosis related groups (DRGs). Patient classification in neonatology is based inter alia on birth weight, with substantial discontinuities in reimbursement at eight different thresholds. These discontinuities create strong incentives to...

Since 2003 German hospitals are reimbursed according to diagnosis related groups (DRGs). Patient classification in neonatology is based inter alia on birth weight, with substantial discontinuities in reimbursement at eight different thresholds. These discontinuities create strong incentives to...

Since 2003 German hospitals are reimbursed according to diagnosis related groups (DRGs). Patient classification in neonatology is based inter alia on birth weight, with substantial discontinuities in reimbursement at eight different thresholds. These discontinuities create strong incentives to...

Since 2003/2004, German hospitals are reimbursed based on a prospective payment scheme (diagnosis related groups, DRGs). Patient classification in neonatology is based inter alia on birth weight, with substantial discontinuities in reimbursement at the relevant thresholds. These discontinuities...

Since 2003 German hospitals are reimbursed according to diagnosis related groups (DRGs). Patient classification in neonatology is based inter alia on birth weight, with substantial discontinuities in reimbursement at eight different thresholds. These discontinuities create strong incentives to...

Since 2003 German hospitals are reimbursed according to diagnosis related groups (DRGs). Patient classification in neonatology is based inter alia on birth weight, with substantial discontinuities in reimbursement at eight different thresholds. These discontinuities create strong incentives to...

Medizinisch technische Innovationen in der Gesundheitswirtschaft benötigen Verfahren zur Refinanzierung neuartiger Leistungen. Ein wichtiges Instrument bildet das Verfahren für Neue Untersuchungs- und Behandlungsmethoden (NUB). Neben dem möglichen Fortschritt in der Versorgung wird allerdings...

Nowadays, public policies often focus on economic values, such as efficiency and financial transparency. Public professionals often resist implementing such policies. We analyze this using the concept of ‘role conflicts’. We use a novel approach by conceptualizing and measuring role...