Methods to determine reimbursement rates for diagnosis related groups (DRG): a comparison of nine European countries

Over the past 20 years, most European countries have introduced DRGs or similar grouping systems as instruments for hospital reimbursement. This paper compares and analyzes the methods used to determine prices for inpatient care within DRGs or similar grouping systems employed in nine EU member stat...

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Bibliographic Details
Published in:Health care management science Vol. 9; no. 3; pp. 215 - 223
Main Authors: Schreyögg, Jonas, Stargardt, Tom, Tiemann, Oliver, Busse, Reinhard
Format: Journal Article
Language:English
Published: Netherlands Springer 01.08.2006
Springer Nature B.V
Series:Health Care Management Science
Subjects:
Accounting
Classification
Data processing
Diagnosis related groups
DRGs
Europe
Fees & charges
Financial Management
Hospital Charges
Hospital costs
Hospital Information Systems
Hospitals
Medicare
Prices
Prospective Payment System
Prospective payment systems
Reimbursement
Reimbursement Mechanisms - organization & administration
Studies
Europe
ISSN:1386-9620, 1572-9389
Online Access:Get full text
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Summary:Over the past 20 years, most European countries have introduced DRGs or similar grouping systems as instruments for hospital reimbursement. This paper compares and analyzes the methods used to determine prices for inpatient care within DRGs or similar grouping systems employed in nine EU member states (i.e., Denmark, France, Germany, Hungary, Italy, Tthe Netherlands, Poland, Spain and England). It categorizes the systems of patient classification used in these nine countries and compares them according to the three steps necessary in order to set prices: 1.) definition of a data sample, 2.) use of trimming methods and plausibility checks and 3.) definition of prices. It concludes with a discussion on the typical development path of DRG systems and the role of additional reimbursement components in this context.
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ISSN:1386-9620
1572-9389
DOI:10.1007/s10729-006-9040-1