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DRG-Systeme in Europa

Anreize, Ziele und Unterschiede in zwölf Ländern

DRG systems in Europe

Incentives, purposes and differences in 12 countries

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Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Aufgrund ihrer Anreize und den damit potenziell einhergehenden Transparenz- und Effizienzgewinnen sind DRG-Systeme flächendeckend in Europa eingeführt worden. Bislang lagen jedoch keine Übersichtsarbeiten zu den unterschiedlichen europäischen DRG-Systemen mit ihren Stärken und Schwächen vor. Im Rahmen des EuroDRG-Projektes wurde diese Forschungslücke geschlossen. Dazu wurden europäische DRG-Systeme in zwölf Ländern mit unterschiedlichsten Gesundheitssystemen untersucht (Deutschland, England, Estland, Finnland, Frankreich, Niederlande, Irland, Österreich, Polen, Portugal, Schweden und Spanien). In der vorliegenden Arbeit werden die wesentlichen Ergebnisse dieser Analyse zusammengefasst. Es wird aufgezeigt, welche Unterschiede hinsichtlich der Politikziele, der Patientenklassifikation, der Datenerfassung, der Preissetzung und der Vergütung in den untersuchten DRG-Systemen bestehen und welche Herausforderungen sich daraus für ihre zukünftige Entwicklung ergeben. Dabei wird deutlich, dass die europäische DRG-Landschaft äußerst heterogen ist. Zwar ist der grundlegende DRG-Ansatz, das Gruppieren vergleichbarer Fälle, in allen Ländern ähnlich, aber im Design der wesentlichen Systembausteine gibt es teilweise große Unterschiede.

Abstract

DRG systems were introduced across Europe based on expected transparency and efficiency gains. However, European DRG systems have not been systematically analysed so far. As a consequence little is known about the relative strengths and weaknesses of different DRG systems. The EuroDRG project closed this research and knowledge gap by systematically analysing and comparing the DRG systems of 12 countries with different health systems (Austria, the UK, Estonia, Finland, France, Germany, Ireland, The Netherlands, Poland, Portugal, Spain and Sweden).This article summarizes the results of this analysis illustrating how DRG systems across Europe differ with regard to policy goals, patient classification, data collection, price setting and actual reimbursement. Moreover, it outlines which main challenges arise within and across the different types of DRG systems. The results show that the European DRG systems are very heterogeneous. Even if the basic DRG approach of grouping similar patients remains the same across countries, the design of the main building blocks differs to a great extent.

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Danksagung

Die Autoren danken allen Beteiligten des EuroDRG-Forschungsprojektes und der Europäischen Kommission für die Förderung dieses Projektes im Rahmen des 7. EU-Forschungsrahmenprogrammes. Weiterhin gilt unser Dank den Gutachtern dieses Beitrages für ihre hilfreichen Kommentare und Anregungen.

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Authors and Affiliations

  1. Fachgebiet Management im Gesundheitswesen, Technische Universität Berlin, Straße des 17. Juni 135, H80, 10623, Berlin, Deutschland

    A. Geissler, D. Scheller-Kreinsen, W. Quentin & R. Busse

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  1. A. Geissler
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  2. D. Scheller-Kreinsen
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  3. W. Quentin
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  4. R. Busse
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Correspondence to A. Geissler.

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Geissler, A., Scheller-Kreinsen, D., Quentin, W. et al. DRG-Systeme in Europa. Bundesgesundheitsbl. 55, 633–642 (2012). https://doi.org/10.1007/s00103-012-1473-8

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  • DOI: https://doi.org/10.1007/s00103-012-1473-8

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