EURODRG

EuroDRG – Diagnosis-Related Groups in Europe: towards Efficiency and Quality

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 Obiettivo del progetto (Objective)

'Payment systems are fundamental to any health care system, introducing powerful incentives and fierce technical design complexities. DRG-systems aim at fairly assessing the costs of patient treatment, taking into account measurable patient characteristics such as diagnosis or comorbidity – but to a varying degree also interventions chosen. Using a representative sample of inpatient data on 10-12 “care episodes” (representing different medical specialties, diagnostic/ therapeutic procedures, usage of innovative devices & drugs) from hospitals in 10 EU countries (AUT, ENG, EST, FIN, FRA, GER, NET, POL, SPA, SWE), the EuroDRG Project aims at studying the importance of structural factors such as wage levels vis-à-vis established patient variables and “medical decision variables” (procedures or using new and emerging technologies) to explain variation in costs within and between European countries. This will allow fair efficiency comparisons among EU hospitals to ensure that DRG-systems provide the intended incentives. A second objective is to investigate the role the quality of care plays to explain costs, an area with practically no European studies but potentially important policy implications. To achieve its objectives, the project is organised in phases: 1. Analysis of national DRG-systems and development of a methodology for trans-national analysis; 2. Trans-national DRG issues - hospital cost functions, efficiency and quality; 3. Translation into practice, synthesis and recommendation. To achieve a high scientific quality and a high policy impact, the strategy involves (based on the successful FP6 HealthBASKET project): encouraging partners to publish in peer-reviewed journals; using excellent links to major international organisations; establishing an EU-wide hospital “benchmarking club”; organising seminars at major conferences; a final conference with invited experts; involving representatives from countries with emerging DRG-systems (Bulgaria, China, India).'

Introduzione (Teaser)

Improved classification of European hospital patients and services will help reimburse costs where applicable, and will provide improved support for patients on many levels. Extended, this initiative could also be beneficial on a global scale.

Descrizione progetto (Article)

Diagnosis-related groups (DRGs), which represent a system to classify hospital patients in particular by diagnosis and procedures in separate categories, have helped streamline hospital payments, reimbursements and financial aid for patients. While DRG-based systems have been implemented in many countries worldwide, there are efforts to harmonise DRGs, both within Europe and with other countries, to improve patient services and cross-border healthcare.

The EU-funded project 'EuroDRG diagnosis-related groups in Europe: towards efficiency and quality' (EuroDRG) aimed to advance the state of the art and improve collaboration between European and other researchers in the field. It also worked on improving how EU Member States organise their health system and apply research to empower policymakers and decision-makers in managing and reforming health-care systems.

The first phase of the project investigated how DRG systems in Europe are designed. It outlined guidelines for policymakers to improve their nation's DRG based hospital payment systems or advance the vision of a pan-European hospital market. This stage involved study of 12 European countries to identify commonalities and differences in objectives, examining issues such as patient classification, DRG weight calculation and hospital payments.

During the second phase the EuroDRG team explored and compared the classification mechanisms of national DRG systems for 10 specific patient groups and conditions (e.g. hip replacement, breast cancer, stroke). The results of these analyses were published in high ranked medical journals. Moreover, EuroDRG researchers compared the performance of DRG systems for the predefined patient groups across European countries and their ability to define homogenous groups of patients so that reimbursement is fair. The team collected patient-level data and specific classification variables used by different DRG systems, looking at how these systems explain variations in resource consumption. They also helped classify the impact of DRG-based hospital payment systems by evaluating costs vs. quality of care. The results were published in a special issue of Health Economics in August 2012.

Within the third and last phase, EuroDRG summarised and distributed its key findings to policymakers, both within and outside Europe. The project encouraged the establishment of a hospital benchmarking group to identify common issues and factors, in order to design effective policies for the emerging pan-European hospital market.

Numerous important presentations and publications have also emerged from the project, supported by policy dialogues and a final conference. One noteworthy achievement was a book, 'Diagnosis related groups in Europe: moving towards transparency, efficiency and quality in hospitals'. The published book with 12 country chapters is available to download online from the http://www.eurodrg.eu (project website), which features many useful downloadable resources on the topic.

Improving policymaking and knowledge on DRG across Europe and beyond can only mean better healthcare and patient services for millions of people around the globe.