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Variable prospective financing in the Danish hospital sector and the development of a Danish case-mix system

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Abstract

This article aims to describe and assess the Danish case-mix system, the cost accounting applied in setting national tariffs and the introduction of variable, prospective payment in the Danish hospital sector. The tariffs are calculated as a national average from hospital data gathered in a national cost database. However, uncertainty, mainly resulting from the definition of cost centres at the individual hospital, implies that the cost weights may not fully reflect the hospital treatment cost. As variable prospective payment of hospitals currently only applies to 20% of a hospital's budget, the incentives and the effects on productivity, quality and equality are still limited.

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References

  1. Docteur E, Oxley H (2003) Health-care systems: lessons from the reform experience. (OECD Health Working Papers 9) OECD, Paris

  2. Bilde L, Ankjaer-Jensen A, Danneskiold-Samsoe B (2005) The “Health Benefit Basket” in Denmark A description of entitlements, actors, and decision-making processes in the curative health sector. European Journal of Health Economics Suppl 6(1):11–17

    Article  Google Scholar 

  3. Pedersen KM, Christiansen T, Bech M (2005) The Danish health care system: evolution—not revolution—in a decentralized system. Health Econ 14(1):41–57

    Article  Google Scholar 

  4. Vallgårda S, Krasnik A, Vrangbæk K (2001) Health care systems in transition. Denmark. (The European Observatory on Health Care Systems, Paris, (European Observatory on Health Care Systems 3(7)))

  5. Jegers M, Kesteloot K, De Graeve D, Gilles W (2002) A typology for provider payment systems in health care. Health Policy 60(3):255–273

    Article  Google Scholar 

  6. Ankjaer-Jensen A, Rath MB (2005) Takststyring af sygehuse. 2. Delrapport: Erfaringer efter et år med takststyring. DSI Institut for Sundhedsvæsen, København (DSI rapport 2005.03)

    Google Scholar 

  7. Bilde L, Ankjaer-Jensen A (2005) Approaches for cost and price assessment in Danish health sector. A description of the approaches used in practice in the Danish health sector to cost and price health services. DSI Danish Institute for Health Services Research, Copenhagen

    Google Scholar 

  8. Ankjaer-Jensen A (2002) DRG—afregning af frit valgs-patienter. Konsekvenser for udbydere af sygehusydelser. DSI Institut for Sundhedsvæsen, København (DSI rapport 2002.04)

    Google Scholar 

  9. Fetter RB, Mills RE, Riedel DC, Thompson JD (1977) The application of diagnostic specific cost profiles to cost and reimbursement control in hospitals. J Med Syst 1(2):137–149

    Article  Google Scholar 

  10. Fetter RB (1991) Diagnosis related groups. Understanding hospital performance. Interfaces 21(1):6–26

    Article  Google Scholar 

  11. Sundhedsministeriet (1995) Måling af sygehuses produktivitet. En DRG-analyse af Nordjyllands Amt. Sundhedsministeriet, København

    Google Scholar 

  12. Sundhedsministeriet (1996) DRG-analyser for danske sygehuse 1993. Sundhedsministeriet, København

    Google Scholar 

  13. http://www.nordclass.uu.se/

  14. http://www.sst.dk/Planlaegning_og_behandling/DRG/DRG_gruppering/Klinisk_validering. aspx?lang=da (only available in Danish)

  15. Averill RF, Goldfield NI, Wynn ME, McGuire TE, Mullin RL, Gregg LW et al (1993) Design of a prospective payment patient classification system for ambulatory care. Health Care Financ Rev 15(1):71–100

    Google Scholar 

  16. Chandler IR (1988) The Yale Cost Model. The second international conference on the management and financing of hospital services. Sydney, Australia February 18–20, 1988. Yale University School of Organization and Management, Health Systems Management Group, Sydney, 221–230

  17. Thompson JD, Averill RF, Fetter RB (1979) Planning, budgeting, and controlling—one look at the future: case-mix cost accounting. Health Serv Res 14(2):111–125

    Google Scholar 

  18. Jackson T (2001) Using computerised patient-level costing data for setting DRG weights: the Victorian (Australia) cost weight studies. Health Policy 56(2):149–163

    Article  Google Scholar 

  19. Leister JE, Stausberg J (2005) Comparison of cost accounting methods from different DRG systems and their effect on health care quality. Health Policy 74(1):46–55

    Article  Google Scholar 

  20. Cots F, Elvira D, Castells X, Dalmau E (2000) Medicare’s DRG-weights in a European environment: the Spanish experience. Health Policy 51(1):31–47

    Article  Google Scholar 

  21. Sundhedsstyrelsen (2005) DRG-enheden. Sundhedsstyrelsens kogebog til dannelse af den patientrelaterede omkostningsdatabase til Takstkatalog 2005. http://www.sst.dk/upload/kogebog2005.pdf. www.sst.dk (September)

  22. Finkler SA, Ward DM (1999) Essentials of cost accounting for health care organizations. 2nd ed. Aspen, Gaithersburg

    Google Scholar 

  23. Brimson JA, Antos J (1994) Activity-based management for service industries, government entities, and nonprofit organizations. Wiley, New York

    Google Scholar 

  24. Ankjaer-Jensen A, Danneskiold-Samsoe B, Svenning AR (2003) Costing of surgical and anaesthesia services. Paper presented at the 19th PCS/E conference, Washington, District of Columbia. DSI Danish Institute for Health Services Research, Copenhagen

  25. Biørn E, Hagen TP, Iversen T, Magnussen J (2002) The effect of activity-based financing on hospital efficiency. A panel data analysis of DEA efficiency scores 1992–2000. Health Economics Research Programme at the University of Oslo. (Working Paper; 2002:8)

  26. Hagen TP, Iversen T, Magnussen J (2004) ISF og sykehusenes effektivitet. Erfaringer fra 1997 og 1998. Helseøkonomisk Forskningsprogram, Universitetet i Oslo. (Skriftserie 2000:1)

  27. Kjerstad E (2000) Prospective funding of somatic hospitals in Norway. Incentives for higher production? Arbeidsnotat. HEB Program for helseøkonomi i Bergen. (Skriftserie i helseøkonomi; nr.10)

  28. Magnussen J, Solstad K (1994) Case-based hospital financing: the case of Norway. Health Policy 28(19):23–26

    Article  Google Scholar 

  29. Ellis RP (1998) Creaming, skimping and dumping: provider competition on the intensive and extensive margins. J Health Econ 17(5):537–555

    Article  Google Scholar 

  30. Pedersen KM, Bech M, Bork Hansen M (2006) Incitamentsstyring i sygehusvæsenet. Virkningen af øget takststyring og tilhørende incitamenter. Syddansk Universitetsforlag, Odense

    Google Scholar 

  31. Corrigan K, Ryan RH (2004) New reimbursement models reward clinical excellence. Healthcare Financing Management 58(11):88–92

    Google Scholar 

  32. Miller ME (2005) Pay for performance in Medicare. Before the Committee on Finance, July 27. 2005. Medpac, Testimoy

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Authors and Affiliations

  1. DSI Danish Institute for Health Services Research, Dampfærgevej 27–29, P.O. Box 2595, DK-2100, Copenhagen, Denmark

    Anni Ankjær-Jensen, Pernille Rosling & Lone Bilde

Authors
  1. Anni Ankjær-Jensen
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  2. Pernille Rosling
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  3. Lone Bilde
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Correspondence to Anni Ankjær-Jensen.

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Ankjær-Jensen, A., Rosling, P. & Bilde, L. Variable prospective financing in the Danish hospital sector and the development of a Danish case-mix system. Health Care Manage Sci 9, 259–268 (2006). https://doi.org/10.1007/s10729-006-9093-1

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  • DOI: https://doi.org/10.1007/s10729-006-9093-1

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