The DRG system has many friends
Financing and structural reform are interrelated. But what can be done if the countries do not follow them? The focus is on per-case flat rates. Even though the Institute for the Remuneration System in Hospitals (InEK) adjusts the DRG system annually, the deficiencies remain clearly visible. Hospitals are sometimes penalized for good medicine, for example by charging more minutes of ventilation. The false incentives have attracted harsh criticism from the medical profession, the health insurance funds and politicians. “Same price for same performance – this is the biggest nonsense that has been trumpeted around the world for 15 years. Some people earn stupidly and stupidly – others are left behind,” judges Stefan Wöhrmann, head of hospital department of the Association of Statutory Health Insurance Funds (VDEK). Hospitals that feel disadvantaged are also speaking out more and more loudly. However, one quite remarkable finding of recent months is that hardly anyone in the scene would like to completely abolish the DRG system. Bernhard Ziegler, head of the Interessenverband Kommunaler Krankenhäuser (IVKK), is the most radical of all: “The DRGs are not basically good or bad, they are like kitchen knives: they are good for peeling potatoes, but if I stab my neighbor with them, they are bad. The list of false incentives is long. “The incentive to increase the volume in the DRG system cannot be argued away, and the question of how to finance reproaches cannot be solved through DRGs,” says Ziegler. But he also concedes that there must be competition for quality and that something similar to a DRG system could certainly continue to exist. Here, too, there is a bunch of half-baked ideas. Translated from German
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