Lungen Markus, Lapsley Irvine
Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany.
J Health Organ Manag. 2003;17(5):360-72. doi: 10.1108/14777260310505138.
From 2003, each inpatient's stay at a German hospital will be reimbursed according to diagnosis related groups. The former German hospital financing system, which consisted partly of per diem rates and partly of per-case rates, was abolished in an attempt to increase efficiency in hospitals. This can be seen as the government's attempt to act on the principles of evidence-based policy. Since there is no strict global budget for inpatient treatment, it is not certain that those diagnosis related groups will actually decrease overall expenditures on hospitals. Also, it is argued that the introduction of diagnosis related groups in Germany may not be the last step in rebuilding the German health care system. The manner, scope and timing of this reform suggests that it will not succeed. Reforms lead to yet more reforms.
自2003年起，德国医院的每位住院患者将根据诊断相关分组进行报销。德国以前的医院融资体系部分基于每日费用率，部分基于按病例收费，现已被废除，旨在提高医院效率。这可以被视为政府按照循证政策原则采取的行动。由于住院治疗没有严格的整体预算，尚不确定这些诊断相关分组是否真的会降低医院的总体支出。此外，有人认为德国引入诊断相关分组可能不是德国医疗体系重建的最后一步。这项改革的方式、范围和时机表明它不会成功。改革引发了更多的改革。
