Cost and Volume Measures of Hospital Services for Germany

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Cost and Volume Measures of Hospital Services for Germany created by Stefan Pierdzioch introduced by Liane Ritter Federal Statistical Office, Germany OECD Working Party on National Accounts in Paris, 14 - 16 October 2008

Content DRG-based financing framework for doctor's facilities Method for cost and volume measures Results

Funding System Based on indicative related gatherings (DRGs) From 2004 for all clinic administrations ( aside from psychiatric and recovery doctor's facilities) 2006: 912 DRGs; 2007: 1082 DRGs 27 noteworthy symptomatic classes (MDCs) DRG-dataset from 2005 Number of medications Cost weights Revenues Base rates Reference value a doctor's facility charges for a normal DRG

Major demonstrative classifications 2006

Major analysis classification MDC 01 „diseases and clutters of the sensory system" finding Economic many-sided quality of the determination (A – I; Z) DRG-Code Example: B75A "Febrile seizures, period of patient < 1 year" DRG B75A

Price of a total treatment (1) Cost weights for DRGs Example: DRG B75A: 0.531 Between 0.106 and 64.899 Valid for one timetable year Published three months before the reference year Base rate (Insurance organization) Negotiated amongst doctor's facilities and medical coverages Up to 2008: by healing facilities; from 2009: by districts (Länder) Actually paid base rate change amid the year Neglected Extra installments Supplements for facultative administrations

Price of a total treatment (2) Calculated DRG-incomes for medicines Price of a treatment = cost weight x base rate Example: DRG B75A in doctor's facility x Cost weight: 0.531 Base rate: 2800 Euros Price of one treatment "febrile seizures, time of patient < 1 year" = 0.531 x 2800 Euros = 1487 Euros DRG-incomes from the DRG-dataset not utilized Small distinction, yearly, past the point of no return

Method (1) Deflation Weighting value advancements with the quantity of medications Market generation Stratification By 27 noteworthy analytic gatherings (MDCs) No issues of regrouping Stability of the structure Weights: medications MDCs From DRG-dataset Only yearly information Nine months after the finish of the reference year Prices: normal incomes per treatment for MDCs Average base rates for all doctor's facilities Average cost weights for MDCs

Method (2) Average cost weight at a MDC Average cost for a MDC = normal cost weight for the MDG x normal base rate Development of the normal costs for MDC Weighted by the quantity of medications for the reference year

Results (1) Quarterly value change for doctor's facility administrations Quarter on quarter correlation, rate

Results (2) Development of doctor's facility administrations Year on year examination, rate

Conclusion From 2005 cost and volume measures for doctor's facilities (aside from psychiatric and restoration doctor's facilities) depends on DRG-information Method: flattening and not volume measure Data prior accessible Quarterly records conceivable Stratification: 27 noteworthy indicative classes (MDC) Weights: Number of medications for each MDC (yearly) Price improvement: computed normal costs for MDC (yearly, quarterly) Influence of around 1000 DRGs - number of medications - cost weights Change of doctor's facilities reference costs (base rate)

Thank you for your consideration Liane Ritter Statistisches Bundesamt, Wiesbaden Phone: +49 (0)611/75-2270 E-mail: liane.ritter@destatis.de