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Alexander Geissler
Title
Prof. Dr.
Last Name
Geissler
First name
Alexander
Email
alexander.geissler@unisg.ch
ORCID
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+41 71 224 30 17
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1 - 10 of 31
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PublicationHow Denmark, England, Estonia, France, Germany, and the USA Pay for Variable, Specialized and Low Volume Care: A Cross-country Comparison of In-patient Payment Systems(Kerman University of Medical Sciences, 2022-05-07)
;Quentin, Wilm ;Stephani, Victor ;Berenson, Robert A. ;Bilde, Lone ;Grasic, Katja ;Sikkut, Riina ;Touré, MariamaBackground Diagnosis-related group (DRG)-based hospital payment can potentially be inadequately low (or high) for highly variable, highly specialized, and/or low volume care. DRG-based payment can be combined with other payment mechanisms to avoid unintended consequences of inadequate payment. The aim of this study was to analyze these other payment mechanisms for acute inpatient care across six countries (Germany, Denmark, England, Estonia, France, the United States [Medicare]). Methods Information was collected about elements excluded from DRG-based payment, the rationale for exclusions, and payment mechanisms complementing DRG-based payment. A conceptual framework was developed to systematically describe, visualise and compare payment mechanisms across countries. Results Results show that the complexity of exclusion mechanisms and associated additional payment components differ across countries. England and Germany use many different additional mechanisms, while there are only few exceptions from DRG-based payment in the Medicare program in the United States. Certain areas of care are almost always excluded (eg, certain areas of cancer care or specialized pediatrics). Denmark and England use exclusion mechanisms to steer service provision for highly complex patients to specialized providers. Conclusion Implications for researchers and policy-makers include: (1) certain areas of care might be better excluded from DRG-based payment; (2) exclusions may be used to incentivize the concentration of highly specialized care at specialized institutions (as in Denmark or England); (3) researchers may apply our analytical framework to better understand the specific design features of DRG-based payment systems.Type: journal articleJournal: International Journal of Health Policy and ManagementScopus© Citations 3 -
PublicationEmergency and urgent care systems in Australia, Denmark, England, France, Germany and the Netherlands - Analyzing organization, payment and reforms.( 2019-01)
;Baier, Natalie ;Bech, Mickael ;Bernstein, David ;Cowling, Thomas E. ;Jackson, Terri ;van Manen, Johan ;Rudkjøbing, AndreasQuentin, WilmINTRODUCTION: Increasing numbers of hospital emergency department (ED) visits pose a challenge to health systems in many countries. This paper aims to examine emergency and urgent care systems, in six countries and to identify reform trends in response to current challenges. METHODS: Based on a literature review, six countries - Australia, Denmark, England, France, Germany and the Netherlands - were selected for analysis. Information was collected using a standardized questionnaire that was completed by national experts. These experts reviewed relevant policy documents and provided information on (1) the organization and planning of emergency and urgent care, (2) payment systems for EDs and urgent primary care providers, and (3) reform initiatives. RESULTS: In the six countries four main reform approaches could be identified: (a) extending the availability of urgent primary care, (b) concentrating and centralizing the provision of urgent primary care, (c) improving coordination between urgent primary care and emergency care, and (d) concentrating emergency care provision at fewer institutions. The design of payment systems for urgent primary care and for emergency care is often aligned to support these reforms. CONCLUSION: Better guidance of patients and a reconfiguration of emergency and urgent care are the most important measures taken to address the current challenges. Nationwide planning of all emergency care providers, closely coordinated reforms and informing patients can support future reforms.Type: journal articleJournal: Health PolicyVolume: 123Issue: 1 -
PublicationPaying hospital specialists: Experiences and lessons from eight high-income countries.( 2018-05)
;Quentin, Wilm ;Wittenbecher, Friedrich ;Ballinger, Geoff ;Berenson, Robert ;Bloor, Karen ;Forgione, Dana A. ;Köpf, Peer ;Kroneman, Madelon ;Serden, Lisbeth ;Suarez, Raúl ;van Manen, Johan W.Busse, ReinhardType: journal articleJournal: Health PolicyVolume: 122Issue: 5 -
PublicationPublic reporting on quality, waiting times and patient experience in 11 high-income countries.(Elsevier, 2016-04)
;Rechel, Bernd ;McKee, Martin ;Haas, Marion ;Marchildon, Gregory P. ;Bousquet, Frederic ;Blümel, Miriam ;van Ginneken, Ewout ;Ashton, Toni ;Saunes, Ingrid Sperre ;Anell, Anders ;Quentin, Wilm ;Saltman, Richard ;Culler, Steven ;Barnes, Andrew ;Palm, WillyNolte, EllenType: journal articleJournal: Health PolicyVolume: 120Issue: 4 -
PublicationHeterogeneity of European DRG Systems and Potentials for a Common EuroDRG System.(Kerman University of Medical Sciences, 2015-03)
;Quentin, WilmBusse, ReinhardDiagnosis-Related Group (DRG) systems across Europe are very heterogeneous, in particular because of different classification variables and algorithms as well as costing methodologies. But, given the challenge of increasing patient mobility within Europe, health systems are forced to incorporate a common patient classification language in order to compare and identify similar patients e.g. for reimbursement purposes. Beside the national adoption of DRGs for a wide range of purposes (measuring hospital activity vs. paying hospitals), a common DRG system can serve as an international communication basis among health administrators and can reduce the national development efforts as it is demonstrated by the NordDRG consortium.Type: journal articleJournal: International Journal of Health Policy and ManagementVolume: 4Issue: 5Scopus© Citations 13 -
PublicationType: journal articleJournal: Das GesundheitswesenVolume: 76Issue: 5
Scopus© Citations 9 -
PublicationDiagnosis related groups in Europe: moving towards transparency, efficiency, and quality in hospitals?( 2013-06-07)
;Busse, Reinhard ;Aaviksoo, Ain ;Cots, Francesc ;Häkkinen, Unto ;Kobel, Conrad ;Or, Zeynep ;O’Reilly, Jacqueline ;Serdén, Lisbeth ;Street, Andrew ;Tan, Siok SwanQuentin, WilmType: journal articleJournal: BMJIssue: 346:f3197 -
PublicationHospital Payment Based On Diagnosis-Related Groups Differs In Europe And Holds Lessons For The United States( 2013-04)
;Quentin, Wilm ;Scheller-Kreinsen, David ;Blümel, MiriamBusse, ReinhardEngland, France, Germany, the Netherlands, and Sweden spend less as a share of gross domestic product on hospital care than the United States while delivering high-quality services. All five European countries have hospital payment systems based on diagnosis-related groups (DRGs) that classify patients of similar clinical characteristics and comparable costs. Inspired by Medicare’s inpatient prospective payment system, which originated the use of DRGs, European DRG systems have implemented different design options and are generally more detailed than Medicare’s system, to better distinguish among patients with less and more complex conditions. Incentives to treat more cases are often counterbalanced by volume ceilings in European DRG systems. European payments are usually broader in scope than those in the United States, including physician salaries and readmissions. These European systems, discussed in more detail in the article, suggest potential innovations for reforming DRG-based hospital payment in the United States.Type: journal articleJournal: Health AffairsVolume: 32Issue: 4 -
PublicationBreast cancer surgery and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries( 2013-10)
;Scheller-Kreinsen, David ;Quentin, WilmBusse, ReinhardResearchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) compared how their DRG systems deal with breast cancer surgery patients. DRG algorithms and indicators of resource consumption were assessed for those DRGs that individually contain at least 1% of all breast cancer surgery patients. Six standardised case vignettes were defined and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems classify breast cancer surgery patients according to different sets of classification variables into three to seven DRGs. Quasi prices for an index case treated with partial mastectomy range from €577 in Poland to €5780 in the Netherlands. Countries award their highest payments for very different kinds of patients. Breast cancer specialists and national DRG authorities should consider how other countries' DRG systems classify breast cancer patients in order to identify potential scope for improvement and to ensure fair and appropriate reimbursement.Type: journal articleJournal: The BreastVolume: 22Issue: 5 -
PublicationType: journal articleJournal: Health EconomicsIssue: Suppl 2