Capital investment is a major concern for public hospitals. Relative to operating expenditures, it has been almost constant for 40 years, despite great changes in technology and patient throughputs. Research studies during the last decade suggest that over that time almost all investment has been on simply replacing existing assets. Per person, the total capital stock has actually declined. How...

INTRODUCTION Jehovah's witnesses refuse blood transfusions. The conflict arises when the patient, entitled to public health treatment, come to surgical centres without blood, to later claim the costs incurred. OBJECTIVES To analyse the legal claims for the refunding of costs by Jehovah's witnesses treated outside the public health system. To make a cost comparison regarding this, using Diagno...

The German hospital market has been subject over the past two decades to a variety of healthcare reforms. Particularly the introduction of diagnosis-related groups (DRGs) in 2004 aimed to increase efficiency of hospitals. The objective of the paper is to review recent studies comparing the efficiency of German public, private non-profit and private for-profit hospitals. The results of the studi...

182 Physician Payment Policy in the 101st Congress Paul B. Ginsburg The Medicare Physician Fee Freeze Janet B. Mitchell, Gerard Wedig, and Jerry Cromwell Prospective Payment to Medical Staffs: A Proposal W. Pete Welch A Competitive Bidding Approach to Physician Payment Jeffrey S. McCombs Medicare Mandatory Assignment: An Unnecessary Risk? John Holahan and Stephen Zuckerman Paying Physicians in ...

In 2000, Germany selected the Australian DRG system as a base for a national standard German version (now called German DRGs, or simply G-DRGs). No serious consideration has been given thus far to major changes in the classification, because there are many practical issues that must be addressed within a short time-scale, given the German federal government’s requirement that per case payment b...

In this article, alternative methodologies for recalibration of the diagnosis-related group (DRG) weights are examined. Based on 1984 data, cost and charge-based weights are less congruent than those calculated with 1981 data. Previous studies using 1981 data demonstrated that cost- and charge-based weights were not very different. Charge weights result in higher payments to surgical DRGs and l...

A growing body of research indicates that severity-adjustment alone does not adequately explain legitimate differences in charges, costs, and length of stays within diagnosis related groups (DRGs) across providers. In order to validly compare resource utilization across providers, other patient attributes such as age and the number of complications and comorbidities (CCs) managed during the pat...

BACKGROUND Diagnosis Related Group (DRG) payment is preferred by healthcare reform in various countries but its implementation in resource-limited countries has not been fully explored. OBJECTIVES This study was aimed (1) to compare the characteristics of hospitals in Thailand that were audited with those that were not and (2) to develop a simplified scale to measure hospital coding practice....

Cream skimming can be defined as the selective treatment of patients that demand few resources while providing high economic refunds. We test whether cream skimming occurs after the introduction of DRG-based activity-based financing (ABF) in Norway in 1997 and if the problem further increased after the 2002 organizational reform when hospitals were turned into trusts. The DRG-system offers the ...

We use the introduction of diagnosis related groups (DRGs) in German neonatology to study the determinants of upcoding. Since 2003, reimbursement is based inter alia on birth weight, with substantial discontinuities at eight thresholds. These discontinuities create incentives to upcode preterm infants into classes of lower birth weight. Using data from the German birth statistics 1996-2010 and ...