Transition to Diagnosis-Related Group Payments for Health : Lessons from Case Studies

This book examines how nine different health systems--U.S. Medicare, Australia, Thailand, Kyrgyz Republic, Germany, Estonia, Croatia, China (Beijing) and the Russian Federation--have transitioned to using case-based payments, and especially diagnosis-related groups (DRGs), as part of their provider...

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Main Authors:	Bredenkamp, Caryn, Bales, Sarah, Kahur, Kristiina
Format:	Book
Language:	English
Published:	Washington, DC: World Bank 2019
Subjects:	MEDICARE HEALTH SYSTEM HEALTH INSURANCE HEALTHCARE FUNDING
Online Access:	https://documents.worldbank.org/en/publication/documents-reports/documentdetail/895741576646353914/transition-to-diagnosis-related-group-payments-for-health-lessons-from-case-studies http://hdl.handle.net/10986/33034

id	okr-10986-33034
recordtype	oai_dc
spelling	okr-10986-330342021-04-23T14:05:17Z Transition to Diagnosis-Related Group Payments for Health : Lessons from Case Studies Bredenkamp, Caryn Bales, Sarah Kahur, Kristiina Bredenkamp, Caryn Bales, Sarah Kahur, Kristiina MEDICARE HEALTH SYSTEM HEALTH INSURANCE HEALTHCARE FUNDING This book examines how nine different health systems--U.S. Medicare, Australia, Thailand, Kyrgyz Republic, Germany, Estonia, Croatia, China (Beijing) and the Russian Federation--have transitioned to using case-based payments, and especially diagnosis-related groups (DRGs), as part of their provider payment mix for hospital care. It sheds light on why particular technical design choices were made, what enabling investments were pertinent, and what broader political and institutional issues needed to be considered. The strategies used to phase in DRG payment receive special attention. These nine systems have been selected because they represent a variety of different approaches and experiences in DRG transition. They include the innovators who pioneered DRG payment systems (namely the United States and Australia), mature systems (such as Thailand, Germany, and Estonia), and countries where DRG payments were only introduced within the past decade (such as the Russian Federation and China). Each system is examined in detail as a separate case study, with a synthesis distilling the cross-cutting lessons learned. This book should be helpful to those working on health systems that are considering introducing, or are in the early stages of introducing, DRG-based payments into their provider payment mix. It will enhance the reader's understanding of how other countries (or systems) have made that transition, give a sense of the decisions that lie ahead, and offer options that can be considered. It will also be useful to those working in health systems that already include DRG payments in the payment mix but have not yet achieved the anticipated results. 2019-12-17T17:39:32Z 2019-12-17T17:39:32Z 2020 Book https://documents.worldbank.org/en/publication/documents-reports/documentdetail/895741576646353914/transition-to-diagnosis-related-group-payments-for-health-lessons-from-case-studies 978-1-4648-1521-8 http://hdl.handle.net/10986/33034 English International Development in Focus; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank Washington, DC: World Bank Publications & Research Publications & Research :: Publication Australia China Croatia Estonia Germany Kyrgyz Republic Russian Federation Thailand United States
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	English
topic	MEDICARE HEALTH SYSTEM HEALTH INSURANCE HEALTHCARE FUNDING
spellingShingle	MEDICARE HEALTH SYSTEM HEALTH INSURANCE HEALTHCARE FUNDING Bredenkamp, Caryn Bales, Sarah Kahur, Kristiina Transition to Diagnosis-Related Group Payments for Health : Lessons from Case Studies
geographic_facet	Australia China Croatia Estonia Germany Kyrgyz Republic Russian Federation Thailand United States
relation	International Development in Focus;
description	This book examines how nine different health systems--U.S. Medicare, Australia, Thailand, Kyrgyz Republic, Germany, Estonia, Croatia, China (Beijing) and the Russian Federation--have transitioned to using case-based payments, and especially diagnosis-related groups (DRGs), as part of their provider payment mix for hospital care. It sheds light on why particular technical design choices were made, what enabling investments were pertinent, and what broader political and institutional issues needed to be considered. The strategies used to phase in DRG payment receive special attention. These nine systems have been selected because they represent a variety of different approaches and experiences in DRG transition. They include the innovators who pioneered DRG payment systems (namely the United States and Australia), mature systems (such as Thailand, Germany, and Estonia), and countries where DRG payments were only introduced within the past decade (such as the Russian Federation and China). Each system is examined in detail as a separate case study, with a synthesis distilling the cross-cutting lessons learned. This book should be helpful to those working on health systems that are considering introducing, or are in the early stages of introducing, DRG-based payments into their provider payment mix. It will enhance the reader's understanding of how other countries (or systems) have made that transition, give a sense of the decisions that lie ahead, and offer options that can be considered. It will also be useful to those working in health systems that already include DRG payments in the payment mix but have not yet achieved the anticipated results.
author2	Bredenkamp, Caryn
author_facet	Bredenkamp, Caryn Bredenkamp, Caryn Bales, Sarah Kahur, Kristiina
format	Book
author	Bredenkamp, Caryn Bales, Sarah Kahur, Kristiina
author_sort	Bredenkamp, Caryn
title	Transition to Diagnosis-Related Group Payments for Health : Lessons from Case Studies
title_short	Transition to Diagnosis-Related Group Payments for Health : Lessons from Case Studies
title_full	Transition to Diagnosis-Related Group Payments for Health : Lessons from Case Studies
title_fullStr	Transition to Diagnosis-Related Group Payments for Health : Lessons from Case Studies
title_full_unstemmed	Transition to Diagnosis-Related Group Payments for Health : Lessons from Case Studies
title_sort	transition to diagnosis-related group payments for health : lessons from case studies
publisher	Washington, DC: World Bank
publishDate	2019
url	https://documents.worldbank.org/en/publication/documents-reports/documentdetail/895741576646353914/transition-to-diagnosis-related-group-payments-for-health-lessons-from-case-studies http://hdl.handle.net/10986/33034
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Transition to Diagnosis-Related Group Payments for Health : Lessons from Case Studies

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