ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2024
Country-level effects of diagnosis-related groups: evidence from Germany's comprehensive reform of hospital payments.
Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Physicians' and Hospital Administrators' Perspectives of Diagnosis-Related Groups (DRGs) in High-Income Countries: A Systematic Review.TheScientificWorldJournal · 2026Pooled it
- Article
- Hospital Length of Stay and Associated Factors in Patients with Oral Cavity Cancer in Germany: A Retrospective Multicenter Analysis of Inpatient Administrative Data.Reports (MDPI) · 2026Article
- Evaluating departmental performance and reimbursement-cost pricing distortions under DRG-based payment: evidence from a tertiary hospital in China.BMC health services research · 2026Article
- Ethical perceptions of DRG-based hospital financing among physicians and hospital managers in Germany: a cross-sectional survey.BMC medical ethics · 2026Article
- Financing Regimes and Case-Mix Complexity in Psychiatric Hospitals Beyond the Pandemic Shock-Insights from a Regional European Healthcare System.Healthcare (Basel, Switzerland) · 2026Article
- Evaluating the efficacy of smoke management technologies in laparoscopic sleeve gastrectomy: insights from a prospective, single-centre comparative study.Scientific reports · 2026Article
- Impact of the volume-based procurement for intraocular lenses combined with the diagnosis-related group's payment reform on hospitalization costs and expenditure structure among cataract patients: an interrupted time series analysis.Frontiers in public health · 2026Article
- How does DRG reform affect length of stay and hospitalization costs in traditional Chinese medicine hospitals?-an empirical analysis using interrupted time-series model from two cities in western China.Frontiers in public health · 2026Article
- Policy frameworks for promoting public hospital development in major economies: implications for China.Frontiers in public health · 2026Review
- A study on the impact of DRG payment reform on hospitalization costs and outcomes of patients with fractures and intervertebral disc herniations.Frontiers in public health · 2026Article
- The impact of DRG payment reform on stroke inpatient costs: a propensity score matching and difference-in-differences analysis of a large public hospital in Northeast China.BMC public health · 2025Article
- Persistent inconsistencies in patient cost variability within the French DRG classification system over the 2012-2019 period.Health economics review · 2025Article
- Lower ambulatory care availability and greater hospital capacity are associated with higher hospital case volumes.Research in health services & regions · 2025Article
- Multidisciplinary DRG management for rational medication in obstetrics: a cost analysis in Zhejiang Province.BMC health services research · 2025Article
- Diagnosis-Related Group-Based Financing of Gynecologic Oncology Clinics: A Systematic Review.Healthcare (Basel, Switzerland) · 2025Review
- How DRG Payment Reform Shapes Inpatient Neurological Care in an Underdeveloped Region: Evidence from a Controlled Interrupted Time Series Study in Yunnan, China.Risk management and healthcare policy · 2025Article
- Impact of DRG policy on the performance of tertiary hospital inpatient services in Chongqing, China: an interrupted time series study, 2020-2023.Frontiers in public health · 2025Article
- A study of the impact of DIP payment reform on coronary heart disease hospitalization costs and equity.Frontiers in public health · 2025Article
- Unpacking the cost implications of diagnosis-related groups reform for lumbar disc herniation patients in Chinese medicine: a closer look at evidence from China.Frontiers in public health · 2025Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hospitals account for about 40% of all healthcare expenditure in high-income countries and play a central role in healthcare provision. The ways in which they are paid, therefore, has major implications for the care they provide. However, our knowledge about reforms that have been made to the various payment schemes and their country-level effects is surprisingly thin. This study examined the uniquely comprehensive introduction of diagnosis-related groups (DRGs) in Germany, where DRGs function as the sole pricing, billing, and budgeting system for hospitals and almost exclusively determine hospital revenue. The introduction of DRGs, therefore, completely overhauled the previous system based on per diem rates, offering a unique opportunity for analysis. Using aggregate data from the Organisation for Economic Co-operation and Development and recent advances in econometrics, we analyzed how hospital activity and efficiency changed in response to the reform. We found that DRGs in Germany significantly increased hospital activity by around 20%. In contrast to earlier studies, we found that DRGs have not necessarily shortened the average length of stay.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.