Transition To Diagnosis Related Group Drg Payments For Health

Author : Caryn Bredenkamp,Sarah Bales,Kristiina Kahur
Publisher : World Bank Publications
Page : 69 pages
File Size : 53,6 Mb
Release : 2019-12-19
Category : Medical
ISBN : 9781464815218

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Transition to Diagnosis-Related Group (DRG) Payments for Health by Caryn Bredenkamp,Sarah Bales,Kristiina Kahur Pdf

This book examines how nine different health systems--U.S. Medicare, Australia, Thailand, Kyrgyz Republic, Germany, Estonia, Croatia, China (Beijing) and the Russian Federation--have transitioned to using case-based payments, and especially diagnosis-related groups (DRGs), as part of their provider payment mix for hospital care. It sheds light on why particular technical design choices were made, what enabling investments were pertinent, and what broader political and institutional issues needed to be considered. The strategies used to phase in DRG payment receive special attention. These nine systems have been selected because they represent a variety of different approaches and experiences in DRG transition. They include the innovators who pioneered DRG payment systems (namely the United States and Australia), mature systems (such as Thailand, Germany, and Estonia), and countries where DRG payments were only introduced within the past decade (such as the Russian Federation and China). Each system is examined in detail as a separate case study, with a synthesis distilling the cross-cutting lessons learned. This book should be helpful to those working on health systems that are considering introducing, or are in the early stages of introducing, DRG-based payments into their provider payment mix. It will enhance the reader's understanding of how other countries (or systems) have made that transition, give a sense of the decisions that lie ahead, and offer options that can be considered. It will also be useful to those working in health systems that already include DRG payments in the payment mix but have not yet achieved the anticipated results.

Author : Reinhard Busse,Alexander Geissler,Wilm Quentin,Miriam Wiley
Publisher : McGraw-Hill Education (UK)
Page : 490 pages
File Size : 40,6 Mb
Release : 2011-11-16
Category : Medical
ISBN : 9780335245581

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EBOOK: Diagnosis-Related Groups in Europe: Moving towards transparency, efficiency and quality in hospitals by Reinhard Busse,Alexander Geissler,Wilm Quentin,Miriam Wiley Pdf

Diagnosis Related Group (DRG) systems were introduced in Europe to increase the transparency of services provided by hospitals and to incentivise greater efficiency in the use of resources invested in acute hospitals. In many countries, these systems were also designed to contribute to improving – or at least protecting – the quality of care. After more than a decade of experience with using DRGs in Europe, this book considers whether the extensive use of DRGs has contributed towards achieving these objectives. Written by authors with extensive experience of these systems, this book is a product of the EuroDRG project and constitutes an important resource for health policy-makers and researchers from Europe and beyond. The book is intended to contribute to the emergence of a ‘common language’ that will facilitate communication between researchers and policy-makers interested in improving the functioning and resourcing of the acute hospital sector. The book includes: A clearly structured introduction to the main ‘building blocks’ of DRG systems An overview of key issues related to DRGs including their impact on efficiency, quality, unintended effects and technological innovation in health care 12 country chapters - Austria, England, Estonia, Finland, France, Germany, Ireland, the Netherlands, Poland, Portugal, Spain and Sweden Clearly structured and detailed information about the most important DRG system characteristics in each of these countries Useful insights for countries and regions in Europe and beyond interested in introducing, extending and/ or optimising DRG systems within the hospital sector

Author : Anonim
Publisher : Unknown
Page : 100 pages
File Size : 47,9 Mb
Release : 1983
Category : Diagnosis
ISBN : MSU:31293012091082

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Diagnosis Related Groups (DRGs) and the Medicare Program by Anonim Pdf

Author : Robert B. Fetter
Publisher : Unknown
Page : 384 pages
File Size : 48,5 Mb
Release : 1991
Category : Diagnosis related groups
ISBN : UOM:49015001318253

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DRGs by Robert B. Fetter Pdf

The DRG Patient classification system. Use of DRGs for managing hospital resources. The product-line management model. Cost accounting and budgeting. Nursing resources. Use of DRGs for financing patient care. Structure of a DRG-based prospective payment system. Using DRGs for international comparisons. DRG analogues for ambulatory care and long-term care

Author : The World Bank;World Health Organization
Publisher : World Bank Publications
Page : 410 pages
File Size : 44,8 Mb
Release : 2019-04-04
Category : Medical
ISBN : 9781464813238

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Healthy China: Deepening Health Reform in China by The World Bank;World Health Organization Pdf

The report recommends that China maintain the goal and direction of its healthcare reform, and continue the shift from its current hospital-centric model that rewards volume and sales, to one that is centered on primary care, focused on improving the quality of basic health services, and delivers high-quality, cost-effective health services. With 20 commissioned background studies, more than 30 case studies, visits to 21 provinces in China, the report proposes practical, concrete steps toward a value-based integrated service model of healthcare financing and delivery, including: 1) Creating a new model of people-centered quality integrated health care that strengthens primary care as the core of the health system. This new care model is organized around the health needs of individuals and families and is integrated with higher level care and social services. 2) Continuously improve health care quality, establish an effective coordination mechanism, and actively engage all stakeholders and professional bodies to oversee improvements in quality and performance. 3) Empowering patients with knowledge and understanding of health services, so that there is more trust in the system and patients are actively engaged in their healthcare decisions. 4) Reforming public hospitals, so that they focus on complicated cases and delegate routine care to primary-care providers. 5) Changing incentives for providers, so they are rewarded for good patient health outcomes instead of the number of medical procedures used or drugs sold. 6) Boosting the status of the health workforce, especially primary-care providers, so they are better paid and supported to ensure a competent health workforce aligned with the new delivery system. 7) Allowing qualified private health providers to deliver cost-effective services and compete on a level playing field with the public sector, with the right regulatory oversight, and 8) Prioritizing public investments according to the burden of disease, where people live, and the kind of care people need on a daily basis.

Author : Anonim
Publisher : DIANE Publishing
Page : 80 pages
File Size : 47,6 Mb
Release : 1983
Category : Diagnosis related groups
ISBN : 9781428923904

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Diagnosis Related Groups (DRGs) and the medicare program : implications for medical technology. by Anonim Pdf

Author : Institute of Medicine,Roundtable on Evidence-Based Medicine
Publisher : National Academies Press
Page : 852 pages
File Size : 55,8 Mb
Release : 2011-01-17
Category : Medical
ISBN : 9780309144339

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The Healthcare Imperative by Institute of Medicine,Roundtable on Evidence-Based Medicine Pdf

The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.

Author : OECD,World Health Organization
Publisher : OECD Publishing
Page : 132 pages
File Size : 48,9 Mb
Release : 2015-11-02
Category : Electronic
ISBN : 9789290617327

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Case-based Payment Systems for Hospital Funding in Asia An Investigation of Current Status and Future Directions by OECD,World Health Organization Pdf

The report focuses on a review of the implementation experience of case-based and DRG mechanisms in the Asia and Pacific region, drawing particularly on research in Australia, Japan, New Zealand, the Republic of Korea, Singapore and Thailand.

Author : OECD,World Health Organization,Barber Sarah L,Lorenzoni Luca,Ong Paul
Publisher : OECD Publishing
Page : 298 pages
File Size : 47,7 Mb
Release : 2019-06-26
Category : Electronic
ISBN : 9789264508866

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Price Setting and Price Regulation in Health Care by OECD,World Health Organization,Barber Sarah L,Lorenzoni Luca,Ong Paul Pdf

The objectives of this study are to describe experiences in price setting and how pricing has been used to attain better coverage, quality, financial protection, and health outcomes. It builds on newly commissioned case studies and lessons learned in calculating prices, negotiating with providers, and monitoring changes. Recognising that no single model is applicable to all settings, the study aimed to generate best practices and identify areas for future research, particularly in low- and middle-income settings. The report and the case studies were jointly developed by the OECD and the WHO Centre for Health Development in Kobe (Japan).

Author : Jack Langenbrunner,Cheryl Cashin,Sheila O'Dougherty
Publisher : World Bank Publications
Page : 348 pages
File Size : 54,5 Mb
Release : 2009-01-01
Category : Medical
ISBN : 9780821378243

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Designing and Implementing Health Care Provider Payment Systems by Jack Langenbrunner,Cheryl Cashin,Sheila O'Dougherty Pdf

Strategic purchasing of health services involves a continuous search for the best ways to maximize health system performance by deciding which interventions should be purchased, from whom these should be purchased, and how to pay for them. In such an arrangement, the passive cashier is replaced by an intelligent purchaser that can focus scarce resources on existing and emerging priorities rather than continuing entrenched historical spending patterns.Having experimented with different ways of paying providers of health care services, countries increasingly want to know not only what to do when paying providers, but also how to do it, particularly how to design, manage, and implement the transition from current to reformed systems. 'Designing and Implementing Health Care Provider Payment Systems: How-To Manuals' addresses this need.The book has chapters on three of the most effective provider payment systems: primary care per capita (capitation) payment, case-based hospital payment, and hospital global budgets. It also includes a primer on a second policy lever used by purchasers, namely, contracting. This primer can be especially useful with one provider payment method: hospital global budgets. The volume's final chapter provides an outline for designing, launching, and running a health management information system, as well as the necessary infrastructure for strategic purchasing.

Author : OECD,Divya Srivastava,Michael Mueller,Emily Hewlett
Publisher : Org. for Economic Cooperation & Development
Page : 0 pages
File Size : 49,5 Mb
Release : 2016
Category : Medical care
ISBN : 9264258205

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Better Ways to Pay for Health Care by OECD,Divya Srivastava,Michael Mueller,Emily Hewlett Pdf

Payers for health care are pursuing a variety of policies as part of broader efforts to improve the quality and efficiency of care. Payment reform is but one policy tool to improve health system performance that requires supportive measures in place such as policies with well-developed stakeholder involvement, information on quality, clear criteria for tariff setting, and embedding evaluation as part of the policy process. Countries should not, however, underestimate the significant data challenges when looking at price setting processes. Data access and ways to overcome its fragmentation require well-developed infrastructures. Policy efforts highlight a trend towards aligning payer and provider incentives by using evidence-based clinical guidelines and outcomes to inform price setting. There are signs of increasing policy focus on outcomes to inform price setting. These efforts could bring about system-wide effects of using evidence along with a patient-centred focus to improve health care delivery and performance in the long-run.

Author : Institute of Medicine,Committee on Quality of Health Care in America
Publisher : National Academies Press
Page : 360 pages
File Size : 45,9 Mb
Release : 2001-08-19
Category : Medical
ISBN : 9780309072809

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Crossing the Quality Chasm by Institute of Medicine,Committee on Quality of Health Care in America Pdf

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

Author : Kerm Henriksen
Publisher : Unknown
Page : 526 pages
File Size : 41,8 Mb
Release : 2005
Category : Medical
ISBN : CHI:70548902

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Advances in Patient Safety by Kerm Henriksen Pdf

v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.

Author : Institute of Medicine,Committee on Changing Health Care Systems and Rheumatic Disease
Publisher : National Academies Press
Page : 253 pages
File Size : 41,6 Mb
Release : 1997-02-09
Category : Medical
ISBN : 9780309056830

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Changing Health Care Systems and Rheumatic Disease by Institute of Medicine,Committee on Changing Health Care Systems and Rheumatic Disease Pdf

Market forces are driving a radical restructuring of health care delivery in the United States. At the same time, more and more people are living comparatively long lives with a variety of severe chronic health conditions. Many such people are concerned about the trend toward the creation of managed care systems because their need for frequent, often complex, medical services conflicts with managed care's desires to contain costs. The fear is that people with serious chronic disorders will be excluded from or underserved by the integrated health care delivery networks now emerging. Responding to a request from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, this book reflects the results of a workshop that focused on the following questions: Does the model of managed care or an integrated delivery system influence the types of interventions provided to patients with chronic conditions and the clinical and health status outcomes resulting from those interventions? If so, are these effects quantitatively and clinically significant, as compared to the effects that other variables (e.g., income, education, ethnicity) have on patient outcomes? If the type of health care delivery system appears to be related to patient care and outcomes, can specific organizational, financial, or other variables be identified that account for the relationships? If not, what type of research should be pursued to provide the information needed about the relationship between types of health care systems and the processes and outcomes of care provided to people with serious chronic conditions?

Author : World Health Organization,European Union,Organisation for Economic Co-operation and Development
Publisher : World Health Organization
Page : 188 pages
File Size : 48,8 Mb
Release : 2022-05-31
Category : Health & Fitness
ISBN : 9789240049239

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A system of health accounts 2011 by World Health Organization,European Union,Organisation for Economic Co-operation and Development Pdf

A System of Health Accounts 2011 provides a systematic description of the financial flows related to the consumption of health care goods and services. As demands for information increase and more countries implement and institutionalise health accounts according to the system, the data produced are expected to be more comparable, more detailed and more policy relevant. This publication summarises the System of Health Accounts 2011 (SHA 2011) Manual, which was jointly produced by OECD, the European Commission and WHO. The SHA 2011 Manual itself draws inspiration from and builds on the original manual, published in 2000, and the Gui de to Producing National Health Accounts (2003) to create a single global framework for producing health expenditure accounts that can help track resource flows from sources to uses. The manual is the result of a four-year collaborative effort between OECD, Eurostat and WHO, and sets out in more detail the boundaries, the definitions and the concepts responding to health care systems around the globe - from the simplest to the more complicated.