Alexander Geissler
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Prof. Dr.
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Geissler
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Alexander
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alexander.geissler@unisg.ch
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+41 71 224 30 17
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  • Publication
    Vergütung von spezialisierten, seltenen und kostenvariablen Fällen außerhalb des DRG-Systems: Erfahrungen aus Deutschland, Dänemark, England, Estland, Frankreich und den USA
    (Springer-Verlag GmbH, 2020)
    Stephani, Victor
    ;
    Geissler, Alexander orcid-logo
    ;
    Quentin, Wilm
    ;
    Klauber, Jürgen
    ;
    Geraedts, Max
    ;
    Friedrich, Jörg
    ;
    Wasem, Jürgen
    ;
    Beivers, Andreas
    The aim of this chapter is to compare hospital payment systems across countries, and to identify what payment mechanisms are used beyond DRG-based payments. The focus is on payment mechanisms that aim to account for highly specialized, variable, or low volume care. The following countries were included in the analysis: Germany, Denmark, England, Estonia, France, USA (Medicare Part A). A questionnaire was developed to collect information about elements excluded from DRG-based payment, why this is the case, and what payments are available. The results were summarised in a model which serves to systematically describe, visualise and compare these payment mechanisms. The results show that all countries have implemented financing mechanisms in addition to DRG-based payment. In most cases, a large number of additional payment mechanisms are applied in order to allow adequate reimburse-ment forcomplex, rareorvariablecases. However, their complexity varies. While countries such as England and Germany use many different additional mechanisms, there are significantly fewer exceptions to DRG-based payment in other systems, such as the Medicare program in the US. Apart from that, care areas excluded from DRG-based payment differ significantly. In Denmark, highly specialised services provided in designated hospitals are excluded from DRG-based payment. In England, designated hospitals receive top-up payments when treating highly specialized patients. In view of the necessary and much discussed concentration of (highly) specialised services in Germany, future reforms of the hospital payment system could be inspired by the Danish (or English) examples and create incentives to support the concentration of highly specialized care.
    Type: book section
    URL: https://link.springer.com/chapter/10.1007/978-3-662-60487-8_4
    DOI: 10.1007/978-3-662-60487-8_4
    URI: https://www.alexandria.unisg.ch/handle/20.500.14171/113132
  • Publication
    Benchmarking der Krankenhaus-IT: Deutschland im internationalen Vergleich
    (Springer-Verlag GmbH, 2019)
    Stephani, Victor
    ;
    Busse, Reinhard
    ;
    Geissler, Alexander orcid-logo
    ;
    Klauber, Jürgen
    ;
    Geraedts, Max
    ;
    Friedrich, Jörg
    ;
    Wasem, Jürgen
    Digitalisation is finding its way into German hospitals. However, the level of information technology (IT) utilisation remains unclear. Therefore, this paper analyses the degree of digitalisation of German hospitals from an international perspective. For this purpose, the logic of the “Electronic Medical Record Adoption Model” (EMRAM) is used, which rates hospitals on a scale from 0 (no digitalisation) to 7 (paperless hospital). According to the EMRAM logic, German hospitals achieve an average value of 2.3 and are therefore digitised only below average compared to other countries. The gap to the European average (3.6) has also widened in recent years. Countries such as Turkey (3.8) or the USA (5.3) are much more advanced. Currently, there is not a single hospital at Level 7 in Germany. Other evaluation methods, such as the “European Hospital Survey”, confirm the results of EMRAM and show that Germany is increasingly losing ground in the digital field. The reasons for this poor balance include a lack of investment, data protection concerns, the user-unfriendliness of the IT systems used and the sluggish broadband expansion in Germany. It is important to define achievable goals and to use existing resources carefully for IT expansion. Only by creating uniform standards and a reliable IT infrastructure, new technologies can be implemented sustainably.
    Type: book section
    URL: https://link.springer.com/chapter/10.1007/978-3-662-58225-1_2
    DOI: 10.1007/978-3-662-58225-1_2
    URI: https://www.alexandria.unisg.ch/handle/20.500.14171/99647