案例库 · 财务与会计 · 财务决策 · 2004–2017
这条还没译成中文，下面是英文原文。
Germany priced every hospital case by diagnosis group, and hospitals did more
A single diagnosis-related group priced every inpatient stay; hospital activity rose about 20% in the reform's wake.
German Federal Ministry of Health · German hospitals · health insurers
那一手
German hospitals were paid through budgets tied to capacity and length of stay.
DRGs became the sole pricing, billing and reimbursement basis for inpatient care.
Each case is classified into a group with a set price, so revenue follows cases treated.
Hospitals gained a direct incentive to increase activity and manage each case's cost.
为什么管用
- One national price system makes hospital outputs comparable.
- Revenue follows cases, so the incentive is to treat more and faster.
- Hospitals keep the difference when they treat a case below its price.
- Length of stay and bed occupancy stop being the unit of payment.
可以搬走什么
The price you use to reimburse determines what suppliers optimise: price the case, not the input, and they will compete on cases.
后来呢
Research found DRGs significantly increased hospital activity by around 20%, with inpatient discharges rising from 16.6m in 2004 to 19.4m in 2017. The reform did not necessarily shorten average length of stay, and concerns about over-treatment emerged alongside the activity gains.
资料来源
- Country-level effects of diagnosis-related groups: evidence from Germany's comprehensive reform of hospital payments
- Country-level effects of diagnosis-related groups: evidence from Germany's comprehensive reform of hospital payments
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