[Myocardial infarction as indicator in a time study. DRG-based financing, did it change therapeutic quality?].

In Norway, four hospitals switched from 100% global budgeting to a combination of 40% DRG-based per case payment and 60% fixed grant financing in 1991. In order to assess changes in the quality of care in acute medicine during the two first years after changing the system of financing, delays before initiation of thrombolytic therapy in patients with acute myocardial infarction were registered. The time from arrival in hospital to initiation of thrombolytic therapy was unchanged, median time was 50 minutes in the first registration period and 55 minutes in the second. 45% of the patients in the intensive care unit/coronary care unit with acute myocardial infarction received thrombolytic therapy.