German DRG system and DRG conversion in Poland

DRG since 2003

2005-2009 - convergence phase

Since 2009 they have had a uniform Basic Rate (ZS) (or slight variations by federal state)

100% is reimbursed through DRG, payment for each single HP

Payments for education go outside the DRG budget

They have 22 million HP per year and a budget of about 80 billion EUR

Only 20% of hospitals provide economic data - voluntarily

The DRG group must have a homogeneous distribution of cases not only overall but also in each PHCU

Correct encoding is achieved:

training

coding guidlines

audit

System setup (with treatment times, inliers and outliers) - focus on increasing efficiency

University hospitals: they have more money because they have more difficult patients, not because they have a different ER

other PHCPs do not get into the higher DRG groups because they do not have such patients

tuition is financed entirely independently through the Ministry of Education

in Switzerland, however, UNI hospitals have a different ES, but Mr Braun thinks this is wrong

Evolution from AR- DRG (Australian DRG)

had to change from paying globally per hospital to paying per patient because it would have driven university hospitals into bankruptcy

They rely much more on performances than on diagnoses, because the aforementioned method prevents upcoding

They also consider the category of so-called new medical methods as part of the attributable items

Funding

the agreed budget they receive, they can underpay up to 20% less and receive a max of 35% more

When a country doesn't have perfect data, there is no point in updating along its own axis, because it will do more harm than good. Then it makes much more sense to take the update from the parent DRG country