[Preparing for the G-DRG system: portfolio analysis of the hospitals in Saxony-Anhalt, Germany]

Diagnosis-Related Groups are scheduled for step-by-step introduction into the German hospital system. Initially DRG base rates will be specific to each hospital (i. e. in keeping with the present budget), but eventually (by 2007) a common base rate will be reached in each federal state. This development may have grave financial consequences for some hospitals where initial base rates are above average and hence likely to be reduced. Therefore, we grouped the remunerations paid by the AOK Saxony-Anhalt (i. e. the largest statutory health insurance company in this federal state) for a total of 308,495 hospital cases in fiscal year 2000 according to hospital and diagnoses, expressed them as a percentage difference from the average remuneration, and analysed them jointly with the average length of stay (LOS). We found considerable differences between hospitals in terms of the payments per case and the LOS, independent of the stratification of the cases. For example, Magdeburg University Clinical Centre registered hospitalisations that were short (below average) but expensive (well above average), hence there is less scope for further rationalization of the LOS in this hospital compared to others. Considerable adjustments will become necessary in due course when switching over from hospital-specific base rates to a common regional base rate.