OBJECTIVE This study evaluated the institutional impact of a substance abuse consultation service in a hospital setting. METHOD Treatment and matched comparison groups were compared on five outcome variables: length of stay, total cost, reimbursement, readmission, and appropriateness of care. The treatment group consisted of patients with discharge diagnoses falling into targeted Diagnostic R...

This article explains the origins, development, and passage of the single most influential postwar innovation in medical financing: Medicare's prospective payment system (PPS). Inexorably rising medical inflation and deep economic deterioration forced policymakers in the late 1970s to pursue radical reform of Medicare to keep the program from insolvency. Congress and the Reagan administration e...

The German health care system has been based on the Hospital Financing Act, which the German government introduced in 1972. According to that, the federal states plan hospitals and make investments. The health insurance funds finance the operating costs. But now the Hospital Financing Act is obsolete, because both the health insurance funds and the federal states are in financial trouble and tr...

UNLABELLED Diagnosis related groups (DRGs) are widely used in several countries. Their various versions aim to value the cost of hospital production. In Europe, the patient classification systems and standard weights used are usually the American originals. OBJECTIVES The objective of this study was to analyse the extent to which DRGs and DRG-weights explain patient cost variability. Differen...

BACKGROUND The prospective reimbursement of hospitals through the grouping of patients into a finite number of categories (Diagnosis Related Groups, DRGs), is common to many European countries. However, the specific categories used vary greatly across countries, using different characteristics to define group boundaries and thus those characteristics which result in different payments for treat...

Casemix refers to a mix of patients classified in some way. It describes a system which groups patients by predetermined factors into clinically meaningful and resource homogenous groups to describe the hospital or health service product (a measure of output). A number of patient classification (casemix) systems have been developed for various purposes. The casemix system used by Australian acu...