Breast cancer surgery and diagnosis-related groups (DRGs): Patient classification and hospital reimbursement in 11 European countries |
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| Authors: | David Scheller-Kreinsen Wilm Quentin Alexander Geissler Reinhard Busse |
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| Affiliation: | 1. Department of Health Care Management, Berlin University of Technology, Straße des 17, Juni 135, 10623 Berlin, Germany;2. European Observatory on Health Systems and Policies, Brussels, Belgium;1. Department of Surgery, The Queen Elizabeth Hospital, South Australia, Australia;2. BreastSurgANZ Quality Audit, Australian Safety and Efficacy Register of New Interventional Procedures – Surgical (ASERNIP-S), Royal Australasian College of Surgeons, North Adelaide, Australia;3. Melanoma Institute of Australia, Breast & Oncology Centre, North Sydney, New South Wales, Australia;4. Department of Surgery, Royal Adelaide Hospital, South Australia, Australia;5. Mater Hospital, Department of Surgery, South Brisbane, Queensland, Australia;6. Waikato Clinical School, University of Auckland, Faculty of Medical and Health Sciences, Auckland, New Zealand;7. National Quality Audit, Australian Safety and Efficacy Register of New Interventional Procedures – Surgical (ASERNIP-S), Royal Australasian College of Surgeons, North Adelaide, Australia;1. Department of Medical Physics, Oslo University Hospital, Norway;2. Department of Physics, University of Oslo, Norway;3. Department of Oncology, Oslo University Hospital, Norway;1. Radiotherapiegroep behandellocatie Deventer, Deventer, The Netherlands;2. MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands;3. Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands;1. University Hospital Basel (UHB), Department of Gynecology and Obstetrics, Spitalstrasse 21, CH-4031 Basel, Switzerland;2. Cantonal Hospital Winterthur (CHW), Department of Gynecology and Obstetrics, Brauerstrasse 15, CH-8401 Winterthur, Switzerland;3. Breast Center “SenoSuisse”, Brauerstrasse 15, CH-8401 Winterthur, Switzerland;4. Inselspital Bern, Department of Pediatric Surgery, Freiburgstrasse 18, CH-3010 Bern, Switzerland;5. CHW, Department of Medicine, Division for Geriatrics, Brauerstrasse 15, CH-8401 Winterthur, Switzerland;6. UHB, Department of Oncology, Petersgraben 4, CH-4031 Basel, Switzerland |
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| Abstract: | Researchers 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. |
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