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This book examines how nine different health systems--U.S. Medicare, Australia, Thailand, Kyrgyz Republic, Germany, Estonia, Croatia, China (Beijing) and the Russian Federation--have transitioned to using case-based payments, and especially diagnosis-related groups (DRGs), as part of their provider payment mix for hospital care. It sheds light on why particular technical design choices were made, what enabling investments were pertinent, and what broader political and institutional issues needed to be considered. The strategies used to phase in DRG payment receive special attention. These nine systems have been selected because they represent a variety of different approaches and experiences in DRG transition. They include the innovators who pioneered DRG payment systems (namely the United States and Australia), mature systems (such as Thailand, Germany, and Estonia), and countries where DRG payments were only introduced within the past decade (such as the Russian Federation and China). Each system is examined in detail as a separate case study, with a synthesis distilling the cross-cutting lessons learned. This book should be helpful to those working on health systems that are considering introducing, or are in the early stages of introducing, DRG-based payments into their provider payment mix. It will enhance the reader's understanding of how other countries (or systems) have made that transition, give a sense of the decisions that lie ahead, and offer options that can be considered. It will also be useful to those working in health systems that already include DRG payments in the payment mix but have not yet achieved the anticipated results.

Case-Mix --- Costing --- Diagnostic Related Groups --- Fee for Service --- Global Budget --- Health Financing --- Health System --- Hospital --- Patients --- Provider Payment --- Sustainability

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As part of an effort to understand better the "natural history" of episodes of care among Medicare beneficiaries, this report documents patterns of postacute care use by Medicare patients and explores some factors that may explain these patterns. The research suggests that there are factors unrelated to a patient's medical condition that determine the setting in which postacute care is given. These factors include economic and social circumstances, and characteristics of the discharging hospital. Specifically, whites are significantly more likely to use skilled nursing facility (SNF) care than nonwhites, whereas nonwhites are significantly more likely to use home health care than whites. A similar pattern is repeated at the hospital level: Patients discharged from hospitals with a "disproportionate share" of Medicaid patients are less likely to receive SNF care but more likely to use home health care than are patients discharged from other hospitals. Because SNF and home health care appear to be substitutes for each other, policy measures that affect care in one of these settings will probably affect care in the other.

Nursing homes --- Home care services --- Hospitals --- Older people --- Medicare. --- Diagnostic Related Groups. --- Health Insurance for Aged and Disabled, Title 18. --- Home Care Services --- Rehabilitation. --- Rehabilitation Centers --- Skilled Nursing Facilities --- Utilization --- Rehabilitation services --- Medical care --- utilization.

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Informatique médical --- Medische informatica --- Telemedicine --- Health Care Coalitions --- Quality of Health Care --- Medical telematics --- Medical care --- Diagnosis related groups --- Case mix --- Casemix --- Clinical coding --- Diagnostic related groups --- DRGs (Medical care) --- Groups, Diagnosis related --- Hospital patients --- Hospitals --- Classification --- Prospective payment --- Medical telematics - Congresses --- Medical care - Congresses --- Diagnosis related groups - Congresses

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In 1983, the first patient classification system to be used on a national basis, the Diagnosis Relate Groups (DRGs), was adopted as part of the Prospective Payment System in the United States. This system caught the attention of health policy makers in other countries, and a number of them began to implement similar approaches. What motivated them to adopt these systems? What similarities and differences were there among their experiences in implementing these systems? What can we learn about introducing change into national health systems by comparing their experiences? The Globalization of Managerial Innovation in Health Care answers these and other questions by examining patient classification systems in fifteen different countries throughout the world. The result is a remarkable collection of case studies of how change can be introduced effectively into national health systems as well as a careful synthesis of what can be learned from them.

Diagnosis related groups --- Public health. --- Community health --- Health services --- Hygiene, Public --- Hygiene, Social --- Public health services --- Public hygiene --- Social hygiene --- Health --- Human services --- Biosecurity --- Health literacy --- Medicine, Preventive --- National health services --- Sanitation --- Case mix --- Casemix --- Clinical coding --- Diagnostic related groups --- DRGs (Medical care) --- Groups, Diagnosis related --- Hospital patients --- Hospitals --- Classification --- Prospective payment --- Business, Economy and Management --- Business Management

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Diagnosis-Related Groups --- Diffusion of Innovation. --- Innovation Diffusion --- Diffusion, Innovation --- Culturally Appropriate Technology --- Information Dissemination --- organization & administration. --- Europe. --- Northern Europe --- Southern Europe --- Western Europe --- Diagnosis related groups --- Organizational change --- Diffusion of Innovation --- Change, Organizational --- Organization development --- Organizational development --- Organizational innovation --- Management --- Organization --- Manpower planning --- Case mix --- Casemix --- Clinical coding --- Diagnostic related groups --- DRGs (Medical care) --- Groups, Diagnosis related --- Hospital patients --- Hospitals --- Case studies --- organization & administration --- Classification --- Prospective payment --- Diagnosis-related groups --- Europe [Western ]