Do diagnosis-related groups explain variations in hospital costs and length of stay? - Analyses from the eurodrg project for 10 episodes of care across 10 European countries

摘要

Payment mechanisms represent one of the fundamental building blocks of any health system, introducing powerful incentives for actors in the system and fierce technical design complexities. The move in most countries towards diagnosis-related group (DRG)-based hospital payment systems was driven by the objective of incentivizing hospitals to improve their performance. Prior to the introduction of DRG-based hospital payment systems, countries used two basic mechanisms to pay for hospital care: fee-for-service payments and global budgets. These systems provide a specific set of incentives, which are different from the incentives of DRG-based systems. Therefore, in order to understand the international success of DRG-based systems, it is necessary to be aware of the incentives of these alternative systems and of the objectives that hospital payment systems are supposed to achieve.