Germany will begin a change to per case payment by DRG from January 2003. It has selected the Australian DRG classification as the basis for patient categorisation, in preference to the many other DRG variants around the world. The main aim is increase control over expenditure. We describe some of the reasons for high levels of spending on hospital inpatient care, including the fragmented insur...

The diagnosis related groups (DRG) classification was designed primarily to categorize patients of acute short-stay hospitals in urban areas. As one might expect, many studies have shown it is a less effective predictor of the needs--and consequently the costs of care--of remote and socio-economically disadvantaged communities. One way of improving the equity of funding involves separating the ...

The diagnosis-related groups (DRG's) have classically focused on resources consumed during a hospital stay. DRG's can also be considered categories for describing cases admitted to a hospital. In this article, we illustrate how consistent patterns of variations in admission rates can be used to classify DRG categories according to the Index of Discretionary Admissions. The consistency of variat...

INTRODUCTION Casemix reimbursement was introduced to Singapore in October 1999 using the Australian National Diagnosis Related Groups Version 3.1 (AN-DRGs 3.1). The possible impact of this classification system on a Singapore Children's Hospital is discussed. MATERIALS AND METHODS Data on paediatric patients in KK Women's and Children's Hospital (KKH) were drawn from the inhouse Datamart ware...

Germany will soon begin per case payment by DRG, and preparations are in progress in most hospitals and insurance companies. The Academic Teaching Hospital Munich-Schwabing in Munich decided to explore coding strategies by considering the impact of diagnoses that could be detected by pathology tests. An Australian database was analysed. We detected "discriminating" diagnoses--that is, diagnoses...

This paper inquires into the effects that Diagnosis Related Groups (DRGs) have had on the ability to explain patient-level costs in a specialist paediatrics hospital. Two hedonic models are estimated using 1996/97 New Children's Hospital (NCH) patient level cost data, one with and one without a casemix index (CMI). The results show that the inclusion of a casemix index as an explanatory variabl...

Several authors have suggested that diagnosis-related groups (DRG's) make inadequate allowance for the severity of illness. Before modifications of DRG's are developed, the sources of within-group variation must be precisely defined; not all variation is attributable to the severity of illness. The limitations of the Uniform Hospital Discharge Data Set (UHDDS), of the International Classificati...

• However, newly launched expensive drugs receive specific funding in two countries. In the UK, ‘innovation payments’ can be requested for new treatments. These payments are limited to a period of up to three years. Subsequently, drugs are either reimbursed via the DRG system or added to the high cost drug exclusion list. In Germany, hospitals can request NUBs (Neue Untersuchungsund Behandlungs...