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Alexander Geissler
Title
Prof. Dr.
Last Name
Geissler
First name
Alexander
Email
alexander.geissler@unisg.ch
ORCID
Phone
+41 71 224 30 17
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1 - 10 of 17
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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
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PublicationType: journal articleJournal: Bundesgesundheitsblatt – Gesundheitsforschung – GesundheitsschutzIssue: 55
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PublicationAppendectomy and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries(Springer, 2012-02)
;Quentin, Wilm ;Scheller-Kreinsen, DavidBusse, ReinhardBackground As part of the EuroDRG project, researchers from 11 countries (i.e., Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their diagnosis-related groups (DRG) systems deal with appendectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. Methods National or regional databases were used to identify hospital cases with a diagnosis of appendicitis treated with a procedure of appendectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that together comprised at least 97% of cases. Six standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. Results European DRG systems vary widely: they classify appendectomy patients according to different sets of variables (between two and six classification variables) into diverging numbers of DRGs (between two and 11 DRGs). The most complex DRG is valued 5.1 times more resource intensive than an index case in France but only 1.1 times more resource intensive than an index case in Finland. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the most complex case vignette amount to only 1,005€ in Poland but to 12,304€ in France. Conclusions Large variations in the classification of appendectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons and national DRG authorities should consider how other countries’ DRG systems classify appendectomy patients in order to optimize their DRG system and to ensure fair and appropriate reimbursement.Type: journal articleJournal: Langenbecks Arch Surg.Volume: 397Issue: 2Scopus© Citations 30 -
PublicationLeistungsbewertung von deutschen Krankenhäusern - Stärken, Schwächen und Vergleichbarkeit der bekannten Methoden.( 2011)
;Scheller-Kreinsen, David ;Street, AndrewBusse, ReinhardType: journal articleJournal: Gesundheitsökonomie & QualitätsmanagementVolume: 16Issue: 2 -
PublicationDiagnosis-Related Groups in Europe (EuroDRG): Do they explain variation in hospital costs and length of stay across patients and hospitals?(Wiley-Blackwell, 2012)
;Busse, Reinhard ;Mason, Anne ;Or, Zeynep ;Scheller-Kreinsen, DavidStreet, AndrewType: bookVolume: Health Economics, Volume 21Issue: Supplement 2 -
PublicationTechnologische Innovationen und DRGs: Ein Vergleich der Vergütungsinstrumente in elf europäischen Ländern(Schattauer GmbH, 2012)
;Scheller-Kreinsen, David ;Quentin, Wilm ;Reiche, Claudia ;Röttger, Julia ;Busse, Reinhard ;Klauber, Jürgen ;Garaedts, Max ;Friedrich, JörgWasem, JürgenPayment mechanisms are important factors for the use and diffusion of technological innovation. Nevertheless, there is a lack of knowledge and empirical evidence about the payment instruments and mechanisms used for technological innovation in the inpatient sector across European health care systems. Given this background, this articles discusses the relationships between DRG-based payment systems and technological innovation. Moreover, it analyses available short-term payment instruments for technological innovation and their application across eleven European countries. The article also scrutinizes how technological innovations are integrated into DRG-based payment systems in the long run. We fi nd that long term mechanisms differ with respect to i) the frequency of system updates, and ii) the time-lag to the data used for these updates. Our analysis suggests that one can differentiate between different kinds of short-term payment instruments: on the one hand some countries apply separate payments outside the core scope of DRG-based payment systems. On the other hand countries provide additional payments and cost-outlier funding that operates within the framework or at the margin of DRG-based payment systems. Overall, our analysis suggests that payment approaches in the context of DRG-based pay-ment systems differ substantially across European health care systems. German as well as other European policy makers should pay more attention to the diversity of payment approaches across European health care systems to inform their policy making. -
PublicationIntroduction to DRGs in Europe: Common objectives across different hospital systems(Open University Press and WHO Regional Office for Europe, 2011)
;Quentin, Wilm ;Scheller-Kreinsen, David ;Busse, Reinhard ;Busse, Reinhard ;Quentin, WilmWiley, Miriam -
PublicationGermany: Understanding G-DRGs(Open University Press and WHO Regional Office for Europe, 2011)
;Scheller-Kreinsen, David ;Quentin, Wilm ;Busse, Reinhard ;Busse, Reinhard ;Quentin, WilmWiley, Miriam