Home
News
Research
Publications
Events
People
Press
MSc
Economics Dept
Search
Contact Us
Internal
Page



|
Vrangbæk K, & Bech M, (2004)
‘County Level Responses to the Introduction of DRG Rates for “Extended
Choice” Hospital Patients in Denmark’
Health Policy 67(1): 25-37
- Discusses the effect of introducing DRG payments for patients seeking
health care across county borders.
- The Danish health care system is decentralised
(delivery and financing are county level responsibilities), politically
managed (elected councillors
control budgets) and free at the point of delivery.
- Hospitals are mostly
financed by pre-agreed annual budgets with negotiated performance targets
- not on a ‘per-case’ DRG basis.
- In
1993 ‘extended choice’ was introduced, allowing patients
to seek care across county borders. The response was disappointing (very
little take-up by patients), so incentives were sharpened in 2000 by introducing
DRG rates for cross-border payments.
Key results:
- The authors find that patient choice is predominantly viewed by
councils as a threat to budgetary stability, not a market opportunity.
This is put down to the fact that the possible economic gains from
patient choice are relatively modest while the potential political
problems (from budget overruns and loss of control due to patient
exodus) could be large.
- In 2001 funds from cross-border patients represented
less than 1% of the budgets of most counties.
- Competition may (paradoxically) be
resulting in increased uniformity of delivery structures in Danish
health care. This is attributed to
collusion (or ‘co-operation’) between councils. By choosing
service levels similar to neighbouring counties, budget losses from
patients going elsewhere are minimised.
Top of Page
|