DRGs and inequities among French hospitals: from a new dilemma to another health care policy

Abstract

The unpredictable French health care reform of 1995-96 introduced casemix tools to fund French hospitals at a regional level. After two years (1997-98), health care authorities and hospitals are facing great inequities and inefficiencies (1 to 3) in 22 French regions. Only one region (Ile de France, Paris) is above the national casemix index mean, the Index Synthétique d' Activité, and very few are equal to this national mean. The dilemma for most of the 22 regions under this national mean, and within a region like Rhône-Alpes (Saint Etienne), with inequities from 1 to 2, is to decide whether the main goal of the new health care policy is to reduce inequities and inefficiencies.