[DRG Introduction in Germany. Options for action of hospitals]

Abstract

Background and purpose: The introduction of DRGs in Germany in 2003 enabled the establishment of a compensation system, which combines quality of services and economic viability. This new system leads to an increase in competition among clinics and insurance providers to act as economic as possible. Various options exist for individual hospitals to increase economic viability; these actions, however, need to be identified, categorized and prioritized to enable hospitals to act accordingly. The goal of this analysis is to identify possible actions hospitals can take as a result of the introduction of G-DRGs.

Method: These actions will be divided into strategic and organizational-operational actions, which have a direct implication on the DRG system or conterminal areas. The strategic actions should provide a first step toward developing a comprehensive system under which individual hospitals can determine the best set of actions to reach their respective goals. The organizational-operative dimension then focuses on the concrete individual actions a hospital can take to reach that goal. RESULTS UND CONCLUSION: As a result, this analysis reveals that hospitals should increasingly attempt to find additional sources of income outside the closed-ended sectoral budgets of the public health insurance sector in Germany. Further, hospitals should increasingly focus on optimizing their cost structure according to standard optimization approaches to increase their ability to provide quality services at competitive costs. Finding the right size for each hospital under the new DRG incentivation and compensation structure has become one of the most critical strategic questions each hospital has to answer individually.