Review of Diagnosis-Related Group-Based Financing of Hospital Care

Health Services Research and Managerial Epidemiology

Volumn 3, Issue , 2016, Pages

  Mihailovic, Natasa ^a   Kocic, Sanja ^a,b   Jakovljevic, Mihajlo ^b  

^a Department of Biostatistics and Informatics   (Serbia)

^b University of Kragujevac Medical Faculty   (Serbia)

Author keywords

DRG; efficiency; hospital health services; managed care; payments systems

Indexed keywords

EID: 85014297458     PISSN: None     EISSN: 23333928     Source Type: Journal    
DOI: 10.1177/2333392816647892     Document Type: Review

References (55)

1. The World Health Report: Health Systems Financing: The Path to Universal Coverage. Geneva, Switzerland: World Health Organization; 2010.
2. Rankovic A Rancic N Jovanovic M et al. Impact of imaging diagnostics on the budget—are we spending too much? Vojnosanit Pregl. 2013;70(7):709–711.
3. Jakovljevic M Zugic A Rankovic A Dagovic A. Radiation therapy remains the key cost driver of oncology inpatient treatment. J Med Econ. 2015;18(1):29–36.
4. Langenbrunner JC Cashin C O’Dougherty S. Designing and Implementing Provider Payment Systems: How to Manuals. Washington, DC: The World Bank; 2009.
5. Hervis RM. Impact of DRGs on the medical profession. Clin Lab Sci. 1993;6(3):183–185.
6. Mathauer I Wittenbecher F. Hospital payment systems based on diagnosis-related groups: experiences in low and middle-income countries. Bull World Health Organ. 2013;91(10):746–756.
7. Jakovljevic M Milovanovic O. Growing burden of non-communicable diseases in the emerging health markets: the case of BRICS. Front Public Health. 2015;3:65. doi:10.3389/fpubh.2015.00065.
8. Jakovljevic M Varjacic M Jankovic SM. Cost-effectiveness of ritodrine and fenoterol for treatment of preterm labor in a low-middle-income country: a case study. Value Health. 2008;11(2):149–153.
9. Jakovljevic M Lazic Z Verhaeghe N Jankovic S Gajovic O Annemans L. Direct medical costs of COPD diagnosis and treatment, Eastern vs. Western European country—examples of Serbia and Belgium. Farmeconomia Health Econ Ther Path. 2013;14(4):161–168.
10. Biorac N Jakovljević M Stefanović D Perovic S Janković S. Assessment of diabetes mellitus type 2 treatment costs in the Republic of Serbia. Vojnosanit Pregl. 2009;66(4):271–276.
11. Jakovljevic M Tetsuji Y Chia Ching C et al. Cost–effectiveness of depressive episode pharmacological treatment. Hosp Pharmacol. 2015;2(1):235–245.
12. Jakovljevic M Lazarevic M Jurisevic M Jovanovic MR. When cure becomes an illness—abuse of addictive prescription medicines. Front Pharmacol. 2015;6:193. doi:10.3389/fphar.2015.00193.
13. Jakovljevic M Jovanovic M Rancic N Vyssoki B Djordjevic N. LAT software induced savings on medical costs of alcohol addicts’ care—results from a matched-pairs case-control study. PLoS One. 2014;9(11):e111931.
14. Jakovljevic M Mijailovic Z Jovicic BP et al. Assessment of viral genotype impact to the cost-effectiveness and overall costs of care for PEG-interferon-2α + ribavirine treated chronic hepatitis C patients. Hepat Mon. 2013;13(6):e6750.
15. Velickovic V Simović A Rajković G Lazarević M Jakovljevic M. Improvements in neonatal and childhood medical care—perspective from the Balkans. Front Public Health. 2015;3:206.
16. Cupurdija V Lazic Z Petrovic M et al. Community-acquired pneumonia: economics of inpatient medical care vis-à-vis clinical severity. J Bras Pneumol. 2015;41(1):48–57.
17. Kovacevic A Dragojevic-Simic V Rancic N et al. End-of-life costs of medical care for advanced stage cancer patients. Vojnosanit Pregl. 2015;72(4):334–341.
18. Dagovic A Matter Walstra K Gutzwiller SF, et al. Resource use and costs of newly diagnosed cancer initial medical care. Eur J Oncol. 2014;19(3):166–184.
19. Park M Braun T Carrin G Evans DB. Provider Payments and Cost-Containment Lessons from OECD Countries. Geneva, Switzerland: World Health Organization; 2007.
20. Street A Vitikainen K Bjorvatn A Hvenegaard A. Introducing Activity-Based Financing: A Review of Experience in Australia, Denmark, Norway and Sweden. York, England: Centre for Health Economics University of York; 2007. CHE Research Paper 30.
21. Kjerstad EM. Prospective funding of general hospitals in Norway—incentives for higher production? Int J Health Care Finance Econ. 2003;3(4):231–251.
22. Busse R Schreyögg J Smith PC. Hospital case payment systems in Europe. Health Care Manag Sci. 2006;9(3):211–213.
23. Lavis J Davies H Oxman A Denis JL Golden-Biddle K Ferlie E. Towards systematic reviews that inform health care management and policy-making. J Health Serv Res Policy. 2005;10(1):35–48.
24. Reinhard R Geissler A Quentin W Wiley M. Diagnosis-Related Groups in Europe. Moving Towards Transparency, Efficiency and Quality in Hospitals. Berkshire, England: Open University Press; 2011.
25. Or Z. Implementation of DRG payment in France: issues and recent developments. Health Policy. 2014;117(2):146–150.
26. Ministere de la sante et des sports. Rapport 2010 au Parlement sur la tarification à l’activité (T2A). France. 2010.
27. Theurl E. Reform of hospital financing in Austria: successes, failures, and the way forward. Euro J Health Econ. 2015;16(3):229–234.
28. Theurl E Winner H. The impact of hospital financing on the length of stay: evidence from Austria. Health Policy. 2007;82(3):375–389.
29. WHO Regional Office for Europe. Health Systems in Transition. Germany Health System Review. European Observatory on Health Systems and Policies. 2014.
30. Vogl M. Assessing DRG cost accounting with respect to resource allocation and tariff calculation: the case of Germany. Health Econ Rev. 2012;2(1):15.
31. Fürstenberg T Zich K Nolting H Laschat M Klein S Häussler B. G-DRG impact evaluation. Final report of the first research cycle (2004-2006). IGES Institut, Institut für das Entgeldsystem in Krankenhaus. 2010.
32. Jakovljevic M Groot W Souliotis K. Health care financing and affordability in the emerging global markets. Front Public Health. 2016;4:2. doi:10.3389/fpubh.2016.00002.
33. Jakovljevic M Vukovic M Fontanesi J. Life expectancy and health expenditure evolution in Eastern Europe-DiD and DEA analysis. Expert Rev Pharmacoecon Outcomes Res. 2015;17:1–10. doi:10.1586/14737167.2016.1125293.
34. Kacevicius G. DRGs in Lithuania: Why DRGs and How to Choose from Available Options. Sofia, Bulgaria: National Hospital Insurance Fund; 2011.
35. Romania Radu CP Chiriac DN Vladescu C. Changing patient classification system for hospital reimbursement in Romania. Croat Med J. 2010;5(3):250–258.
36. Endrei D Zemplényi A Molics B Agoston I Boncz I. The effect of performance-volume limit on the DRG based acute care hospital financing in Hungary. Health Policy. 2014;115(2-3):152–156.
37. Bogut M Voncina L Yeh E. Policy Research Working Papers. Washington, DC: World Bank; 2012.
38. Biørn E Hagen P Iversen T Magnussen J. The effect of activity-based financing on hospital efficiency: a panel data analysis of DEA efficiency scores 1992-2000. Health Care Manag Sci. 2003;6(4):271–283.
39. Hagen P Veenstra M Stavem K. Efficiency and Patient Satisfaction in Norwegian Hospitals. Oslo, Norway: University of Oslo, Health Economics Research Program Working Paper; 2006.
40. Mikkola H Keskimäki I Häkkinen U. DRG-related prices applied in a public health care system—can Finland learn from Norway and Sweden? Health Policy. 2002;59(1):37–51.
41. Lorenzoni L Belloni A Sasii F. Health-care expenditure and health policy in the USA versus other high-spending OECD countries. Lancet. 2014;384(9937):3–5.
42. Canadian Institute for Health Information. National Health Expenditure Trends, 1975 to 2010. Ottawa, Canada: Canadian Institute for Health Information; 2010.
43. Sutherland JM. Hospital Payment Mechanisms: An Overview and Options for Canada. Ontario, Canada: Canadian Health Services Research Foundation; 2011.
44. Collier R. Activity-based hospital funding: boon or boondoggle? CMAJ. 2008;178(11):1407–1408.
45. Cylus J Irwin R. The challenges of hospital payment systems. Euro Observer. 2010;12(3):1–12.
46. Street A Maynard A. Activity based financing in England: the need for continual refinement of payment by results. Health Econ Policy Law. 2007;2(4):419–427.
47. Palmer KS Martin D Guyatt G. Prelude to a systematic review of activity-based funding of hospitals: potential effects on cost, quality, access, efficiency, and equity. Open Med. 2013;7(4):94–97.
48. Ettelt S Nolte E. Funding Intensive Care—Approaches in Systems Using Diagnosis-Related Groups. London: The RAND Corporation; 2010.
49. Healy J Sharman E Lokuge B. Australia: health system in review. Health Sys Trans. 2006;8(5):1–158.
50. Biørn E Hagen T Iversen T Magnussen J. How different are hospitals’ responses to a financial reform? The impact on efficiency of activity-based financing. Health Care Manag Sci. 2010;2010(1):1–16.
51. Yin J Lurås H Hagen TP Dahl FA. The effect of activity-based financing on hospital length of stay for elderly patients suffering from heart diseases in Norway. BMC Health Serv Res. 2013;13(1):172.
52. Busato A Below G. The implementation of DRG-based hospital reimbursement in Switzerland: a population-based perspective. Health Res Policy Syst. 2010;8:31.
53. Newhouse J. Do unprofitable patients face access problems? Health Care Financ Rev. 1989;11(2):33–42.
54. Radovanović A Dagović A Jakovljević M. Economics of cancer related medical care: worldwide estimates and available domestic evidence. Arch Oncol. 2011;19(3-4):59–63.
55. Vuković M Gvozdenović BS Gajić T Gajić BS Jakovljević M McCormick BP. Validation of a patient satisfaction questionnaire in primary health care. Public Health. 2012;126(8):710–718.