Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 145 No. 0708 (2015)

Impact of the DRG-based reimbursement system on patient care and professional practise: perspectives of Swiss hospital physicians

  • Margrit Fässler
  • Verina Wild
  • Caroline Clarinval
  • Alois Tschopp
  • Jana Alexandra Faehnrich
  • Nikola Biller-Andorno
DOI
https://doi.org/10.4414/smw.2015.14080
Cite this as:
Swiss Med Wkly. 2015;145:w14080
Published
08.02.2015

Summary

QUESTIONS UNDER STUDY: The reimbursement system SwissDRG sets incentives for hospitals and providers to treat patients in a cost-efficient way. Arising conflicts between the commitment to the patient’s well-being and the economic interests of the hospital can lead to an impairment of quality and equity of health care. We developed and used a monitoring tool to evaluate ethically relevant aspects related to DRGs by surveying physicians.

METHODS: We surveyed a random sample of physicians working in Swiss hospitals, exploring potentially positive and negative effects of DRGs on patient care.

RESULTS: A total of 382 physicians completed the questionnaire (response rate 47%). More than 90% judged quality of health care “very good” or “rather good”, and 83% were satisfied with their job. The majority of physicians gave more consideration to economic issues in their clinical practise than they would have liked and had experienced various forms of over- and under-provision over the past six months. Overall, physicians considered patient-orientation deteriorating since the introduction of DRGs with no gains in efficiency. Professional principles could not be applied in all instances.

CONCLUSIONS: Two years after the introduction of SwissDRG the quality of patient care and the job satisfaction is rated as good by most physicians. However, quality of care could be seriously compromised if more economic pressure is put on physicians in the future. Careful monitoring is needed to ensure that the needed focus on cost-containment and sustainability does not come at the expense of the high performance of the Swiss health care system.

References

  1. Busse R, Geissler A, Quentin W, Wiley M. European Observatory on Health Systems and Policies Series: Diagnosis-Related Groups in Europe. Available from: http://www.euro.who.int/en/about-us/partners/observatory/studies/diagnosis-related-groups-in-europe.
  2. Brügger U. Impact of DRGs: Introducing a DRG reimbursement system: A literature review; Gesundheitspolitik SGf, editor. Bern, Switzerland: 2010.
  3. Bundesgesetz über die Krankenversicherung (KVG) (Spitalfinanzierung). Available from: http://www.admin.ch/opc/de/official-compilation/2008/2049.pdf.
  4. Swiss Medical Association. Standesordnung FMH. Available from: https://www.fmh.ch/ueber_fmh/rechtliche_grundlagen/standesordnung.html.
  5. Fourie C, Biller-Andorno N, Wild V. Systematically Evaluating the Impact of Diagnosis-Related Groups (DRGs) on Health Care Delivery: A Matrix of Ethical Implications. Health Policy. 2014;115:157–64.
  6. Wild V, Pfister E, Biller-Andorno N. Kriterien für die DRG-Begleitforschung aus ethischer Perspektive. Schweiz Arzteztg. 2009;90(40):1553–6.
  7. Wild V, Pfister E, Biller-Andorno N. DRG: Ethik vs. Ökonomie? Bulletin SAMW. 2009;11–5.
  8. Faller H, Grefe C. Geld oder Leben. Die Zeit. 2012;3930–3.
  9. gfs.bern. Gute Patientenversorgung trotz administrativem Aufwand – punktuelle Probleme. Schlussbericht 2013. Available from: http://www.fmh.ch/files/pdf14/2013_12_20_FMH-Begleitstudie_Spitalfinanzierung_Schlussbericht_2013_D.pdf.
  10. Wild V, Pfister E, Biller-Andorno N. Ethical research on the implementation of DRGs in Switzerland – a challenging project. Swiss Med Wkly. 2012;142w13610.
  11. OECD. OECD Reviews of Health Systems: Switzerland 2011. Available from: http://www.oecd-ilibrary.org/content/book/9789264120914-en.
  12. gfs.bern. DRG: Befürchtungen einer zunehmenden Bürokratisierung der Medizin. Schlussbericht. Available from: http://www.fmh.ch/files/pdf9/2012_01_04_Begleitstudie_SwissDRG_Langversion_D.pdf.
  13. Swiss DRG AG. Aims. Available from: http://www.swissdrg.org/de/02_informationen_swissDRG/ziele.asp?navid=11.
  14. Statistik Bfr. Eidgenössisches Departement des Innern EDI. BFS Aktuell. Krankenhausstatistik 2011 – Standardtabellen. Available from: http://www.bfs.admin.ch/bfs/portal/de/index/news/publikationen.html?publicationID=5104.
  15. Kraft E, Hostettler S. 31 858 Ärztinnen und Ärzte garantieren die ärztliche Versorgung. Schweiz Arzteztg. 2013;94(12):453–7.
  16. Simon M. Das deutsche DRG-System: Grundsätzliche Konstruktionsfehler. Dtsch Arztebl International. 2013;110(39):1782–6.
  17. Gesundheit. Grunddaten der Krankenhäuser. Fachserie 12 Reihe 6.1.1. Available from: https://www.destatis.de/DE/Publikationen/Thematisch/Gesundheit/Krankenhaeuser/GrunddatenKrankenhaeuser.html.
  18. Dreimal «Auswirkungen der DRGs»: Ähnliche und völlig unterschiedliche Ergebnisse und Bewertungen dreier Politikfolgen-Studien. Available from: http://www.forum-gesundheitspolitik.de/artikel/artikel.pl?artikel=1775.
  19. Braun B, Buhr P, Klinke S, Müller R, Rosenbrock R. Pauschalpatienten, Kurzlieger und Draufzahler – Auswirkungen der DRGs auf Versorgungsqualität und Arbeitsbedingungen im Krankenhaus. Bern, Switzerland: Huber: 2010.
  20. Braun B. Entwicklung der objektiven und subjektiven Arbeitsbedingungen von Krankenhausärztinnen und -ärzten im DRG-System. Available from: http://www.zes.uni-bremen.de/GAZESse/201001/20091211_BB_Laekh.pdf.
  21. 124. Hauptversammlung Marburger Bund: Fallpauschalensystem sofort korrigieren. Available from: http://www.marburger-bund.de/artikel/allgemein/pressemitteilungen/2013/marburger-bund-fallpauschalensystem-sofort-korrigieren.
  22. Krankenhaus Barometer. Umfrage 2013. Available from: https://www.dki.de/service/publikationen.
  23. Krankenhausbarometer. Umfrage 2012. Available from: https://www.dki.de/sites/default/files/publikationen/krankenhaus-barometer-2012.pdf.
  24. Krankenhausbarometer. Umfrage 2011. Available from: https://www.dki.de/sites/default/files/publikationen/krankenhaus_barometer_2011.pdf.
  25. Ankowitsch E. Arzt-Patient-Beziehung: Vertrauen über Jahrzehnte weggespart. Dtsch Ärztebl International. 2013;110(42):1940.
  26. Aasland OG, Hagen TP, Martinussen PE. The 2002 hospital reform – physicians’ views. Tidsskr Nor Laegeforen. 2007;127(17):2218–21.
  27. Patel K. Physicians and DRGs. Hospital management alternatives. Eval Health Prof. 1988;11(4):487–505.
  28. Notman M, Howe KR, Rittenberg W, Bridgham R, Holmes MM, Rovner DR. Social policy and professional self-interest: physician responses to DRGs. Soc Sci Med. 1987;25(12):1259–67.

Most read articles by the same author(s)

<< < 1 2