Department for Health Care Management, Berlin University of Technology, Berlin, Germany.
Value Health. 2011 Dec;14(8):1166-72. doi: 10.1016/j.jval.2011.07.001. Epub 2011 Sep 9.
To assess how diagnosis-related group-based (DRG-based) hospital payment systems in 12 European countries participating in the EuroDRG project pay and incorporate technological innovation.
A standardized questionnaire was used to guide comprehensive DRG system descriptions. Researchers from each country reviewed relevant materials to complete the questionnaire and drafted standardized country reports. Two characteristics of DRG-based hospital payment systems were identified as particularly important: the existence of short-term payment instruments encouraging technological innovation in different countries, and the characteristics of long-term updating mechanisms that assure technological innovation is ultimately incorporated into DRG-based hospital payment systems.
Short-term payment instruments and long-term updating mechanisms differ greatly among the 12 European countries included in this study. Some countries operate generous short-term payment instruments that provide additional payments to hospitals for making use of technological innovation (e.g., France). Other countries update their DRG-based hospital payment systems very frequently and use more recent data for updates.
Generous short-term payment instruments to promote technological innovation should be applied carefully as they may imply rapidly increasing health-care expenditures. In general, they should be granted only if rigorous analyses have demonstrated their benefits. If the evidence remains uncertain, coverage with evidence development frameworks or frequent updates of the DRG-based hospital systems may provide policy alternatives. Once the data and evidence base is substantially improved, future research should empirically investigate how different policy arrangements affect the adoption and use of technological innovation and health-care expenditures.
评估参与 EuroDRG 项目的 12 个欧洲国家的基于诊断相关分组（DRG 组）的医院支付系统如何支付并纳入技术创新。
使用标准化问卷指导全面的 DRG 系统描述。每个国家的研究人员审查相关材料以完成问卷并起草标准化的国家报告。确定了基于 DRG 的医院支付系统的两个特别重要的特征：不同国家存在鼓励技术创新的短期支付工具，以及确保技术创新最终纳入基于 DRG 的医院支付系统的长期更新机制的特征。
本研究纳入的 12 个欧洲国家的短期支付工具和长期更新机制差异很大。一些国家实行慷慨的短期支付工具，为利用技术创新的医院提供额外付款（例如，法国）。其他国家非常频繁地更新其基于 DRG 的医院支付系统，并使用更新的数据进行更新。
为促进技术创新而提供的慷慨的短期支付工具应谨慎使用，因为它们可能意味着医疗保健支出的迅速增加。一般来说，只有在严格分析证明其益处的情况下才应给予这些工具。如果证据仍然不确定，则可以通过证据开发框架或频繁更新基于 DRG 的医院系统来提供政策替代方案。一旦数据和证据基础得到实质性改善，未来的研究应从实证角度研究不同政策安排如何影响技术创新和医疗保健支出的采用和使用。
