Title: Impact of introducing a DRG reimbursement system in an acute impatient hostpital setting : a literature review
Authors : Brügger, Urs
Eichler, Klaus
Conference details: HTAi 7th Annual Meeting Dublin, Ireland 6–9th June 2010
Issue Date: 2010
License (according to publishing contract) : Licence according to publishing contract
Type of review: Not specified
Language : English
Subject (DDC) : 362: Health and social services
Abstract: Background: Diagnosis related groups (DRG) are a reimbursement system used by hospitals in an increasing number of countries. However, there is ongoing debate on the effects and possible side-effects of this type of system. Objectives: To collect evidence about the impact of introducing a DRG reimbursement system in an acute inpatient hospital setting on: (1) health care costs, (2) quality of care and (3) access to care and equity. Design: Literature review (scoping study). Data sources: Searches of PubMed, Cochrane Library and ABI/Inform; conducted between January 1980 and March 2009 and targeted journal articles in English and German. Review methods: Study designs included: Controlled studies, “pre-post” studies, aggregated evidence (reviews). Outcomes: (1) health care costs (e.g., costs, productivity and up-coding), (2) quality of care (e.g., mortality rate, readmission rate and work satisfaction of professionals) and (3) access to care and equity (e.g., waiting lists and indicators for risk selection). Results: The main results regarding the three outcome domains are: (1) The literature suggests that there may have been a reduction of costs and an increase in efficiency following the introduction of DRG. However, there are studies that indicate that costs were not contained and that efficiency may have even gone down. (2) There was no measurable reduction in quality of care if one looks at mortality or readmission rates. Some minor quality reductions in other areas were reported in a few studies. (3) There may have been an adverse effect on equity/equal access; however, the evidence is very weak and the findings do not suggest an effect of large magnitude. Conclusions: The scientific literature seems to suggest that the overall effect of DRG has been limited, both in terms of positive effects (cost containment) and negative effects (reduction in quality of care and equity/equal access).
Departement: School of Management and Law
Organisational Unit: Winterthur Institute of Health Economics (WIG)
Publication type: Conference Paper
URI: https://digitalcollection.zhaw.ch/handle/11475/13196
Appears in Collections:Publikationen School of Management and Law

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