Busse R, Blümel M (2014): Germany: Health system review. Health Systems in Transition. 16(2): 1-296

© European Observatory

The European Observatory on Health Systems has just released a new version of the report on Germany, looking at the German health system at an interesting pint in time: Almost 25 years have elapsed since the fall of the Berlin wall and German reunification. Since then various governments have implemented a number of important reforms in the health sector, including changes in self-governing structures, financing the statutory health insurance system, paying providers and assessing and reimbursing pharmaceuticals. Today the German health care system has a generous benefit basket, one of the highest levels of capacity as well as modest cost-sharing. Expenditure per capita is high and access is good. However, the German health care system also shows areas in need of improvement if compared with other countries. This is demonstrated by the low satisfaction figures with the health system in general and a lack in quality of care, if the outcomes of individual illnesses are analyzed. This more than 300-page health system review on Germany scrutinizes changes and reforms that have taken place since the last report published in 2005 and discusses challenges for the new government in power since the end of 2013. more to: Busse R, Blümel M (2014): Germany: Health system review. Health Systems in Transition. 16(2): 1-296

Busse R, Geissler A, Mason A, Or Z, Scheller-Kreinsen D, Street A (Eds.) (2012): Diagnosis-Related Groups in Europe (EuroDRG): Do they explain variation in hospital costs and length of stay across patients and hospitals? Health Economics, Volume 21

Since the development of the first classification of diagnosis-related groups (DRGs) in the 1970s, the number of DRG systems has proliferated, with many countries developing their own versions, which are periodically overhauled. The original intention was that DRGs would classify patients into a manageable number of resource homogenous groups, and this remains the fundamental basis for classification. However, herein lies a puzzle: is variation in medical practice and resource use so great across countries that each requires its own patient classification system? Or are some DRG systems better than others at categorising patients into resource homogenous groups? more to: Busse R, Geissler A, Mason A, Or Z, Scheller-Kreinsen D, Street A (Eds.) (2012): Diagnosis-Related Groups in Europe (EuroDRG): Do they explain variation in hospital costs and length of stay across patients and hospitals? Health Economics, Volume 21

Busse R, Geissler A, Quentin W, Wiley M (Eds.) (2011): Diagnosis-Related Groups in Europe - Moving towards transparency, efficiency and quality in hospitals. Open University Press

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Diagnosis-related group systems were introduced throughout Europe for similar reasons: to increase transparency, and to improve efficiency and assure quality in hospitals. After more than a decade of experience with using diagnosis-related groups in Europe, it's time to consider whether their extensive use has contributed towards achieving these aims. more to: Busse R, Geissler A, Quentin W, Wiley M (Eds.) (2011): Diagnosis-Related Groups in Europe - Moving towards transparency, efficiency and quality in hospitals. Open University Press

BUSSE R, SCHREYÖGG J, SMITH P (2008): Variability in healthcare treatment costs amongst nine EU countries – results from HealthBASKET project (Editorial). Health Economics 17(S1): 1-8

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Patient mobility gives rise to some fundamental information requirements, such as the nature of the basket of services offered in the different Member States, how these are defined, how often they are used for particular patients, what their costs are, what prices are paid for them, the quality with which they are delivered, and their cost-effectiveness. This knowledge will enable both Member States and the European Commission to formulate coherent policies on patient mobility in a way that will preserve both the financial viability of existing health systems and the treasured principles of universality, equity and accessibility. Further, if patients are to benefit from the opportunity offered by the European Union’s emerging healthcare market, they too will need to know the nature, quality and costs of services available elsewhere. Finally, international comparison based on good quality data is an important tool for learning from best practice within and between countries. However, international comparisons of service, cost and quality data are currently not routinely available for individual treatments. Up to now, healthcare cost comparisons have been usually made at an aggregate level and variations have been identified at the macro-level, e.g. in purchasing power parities (PPPs) per capita, as a percentage of GDP, distribution of expenditure per sector. Most fundamentally, analysis of international variation in the costs of individual services at the micro-level is diff... more to: BUSSE R, SCHREYÖGG J, SMITH P (2008): Variability in healthcare treatment costs amongst nine EU countries – results from HealthBASKET project (Editorial). Health Economics 17(S1): 1-8