Impact of the DRG-based reimbursement system on patient care and professional practise: perspectives of Swiss hospital physicians
QUESTIONS UNDER STUDY: The reimbursement system SwissDRG sets incentives for hospitals and providers to treat patients in a cost-efficient way. Arising conflicts between the commitment to the patient’s well-being and the economic interests of the hospital can lead to an impairment of quality and e...
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2015-02-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/2010 |
| _version_ | 1811288902671007744 |
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| author | Margrit Fässler Verina Wild Caroline Clarinval Alois Tschopp Jana Alexandra Faehnrich Nikola Biller-Andorno |
| author_facet | Margrit Fässler Verina Wild Caroline Clarinval Alois Tschopp Jana Alexandra Faehnrich Nikola Biller-Andorno |
| author_sort | Margrit Fässler |
| collection | DOAJ |
| description |
QUESTIONS UNDER STUDY: The reimbursement system SwissDRG sets incentives for hospitals and providers to treat patients in a cost-efficient way. Arising conflicts between the commitment to the patient’s well-being and the economic interests of the hospital can lead to an impairment of quality and equity of health care. We developed and used a monitoring tool to evaluate ethically relevant aspects related to DRGs by surveying physicians.
METHODS: We surveyed a random sample of physicians working in Swiss hospitals, exploring potentially positive and negative effects of DRGs on patient care.
RESULTS: A total of 382 physicians completed the questionnaire (response rate 47%). More than 90% judged quality of health care “very good” or “rather good”, and 83% were satisfied with their job. The majority of physicians gave more consideration to economic issues in their clinical practise than they would have liked and had experienced various forms of over- and under-provision over the past six months. Overall, physicians considered patient-orientation deteriorating since the introduction of DRGs with no gains in efficiency. Professional principles could not be applied in all instances.
CONCLUSIONS: Two years after the introduction of SwissDRG the quality of patient care and the job satisfaction is rated as good by most physicians. However, quality of care could be seriously compromised if more economic pressure is put on physicians in the future. Careful monitoring is needed to ensure that the needed focus on cost-containment and sustainability does not come at the expense of the high performance of the Swiss health care system.
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| first_indexed | 2024-04-13T03:45:41Z |
| format | Article |
| id | doaj.art-50540f7905ab45e7a9160bb014a589c5 |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-13T03:45:41Z |
| publishDate | 2015-02-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-50540f7905ab45e7a9160bb014a589c52022-12-22T03:04:01ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972015-02-01145070810.4414/smw.2015.14080Impact of the DRG-based reimbursement system on patient care and professional practise: perspectives of Swiss hospital physiciansMargrit FässlerVerina WildCaroline ClarinvalAlois TschoppJana Alexandra FaehnrichNikola Biller-Andorno QUESTIONS UNDER STUDY: The reimbursement system SwissDRG sets incentives for hospitals and providers to treat patients in a cost-efficient way. Arising conflicts between the commitment to the patient’s well-being and the economic interests of the hospital can lead to an impairment of quality and equity of health care. We developed and used a monitoring tool to evaluate ethically relevant aspects related to DRGs by surveying physicians. METHODS: We surveyed a random sample of physicians working in Swiss hospitals, exploring potentially positive and negative effects of DRGs on patient care. RESULTS: A total of 382 physicians completed the questionnaire (response rate 47%). More than 90% judged quality of health care “very good” or “rather good”, and 83% were satisfied with their job. The majority of physicians gave more consideration to economic issues in their clinical practise than they would have liked and had experienced various forms of over- and under-provision over the past six months. Overall, physicians considered patient-orientation deteriorating since the introduction of DRGs with no gains in efficiency. Professional principles could not be applied in all instances. CONCLUSIONS: Two years after the introduction of SwissDRG the quality of patient care and the job satisfaction is rated as good by most physicians. However, quality of care could be seriously compromised if more economic pressure is put on physicians in the future. Careful monitoring is needed to ensure that the needed focus on cost-containment and sustainability does not come at the expense of the high performance of the Swiss health care system. https://www.smw.ch/index.php/smw/article/view/2010SwitzerlandquestionnaireethicssurveyDRGscost-containment |
| spellingShingle | Margrit Fässler Verina Wild Caroline Clarinval Alois Tschopp Jana Alexandra Faehnrich Nikola Biller-Andorno Impact of the DRG-based reimbursement system on patient care and professional practise: perspectives of Swiss hospital physicians Swiss Medical Weekly Switzerland questionnaire ethics survey DRGs cost-containment |
| title | Impact of the DRG-based reimbursement system on patient care and professional practise: perspectives of Swiss hospital physicians |
| title_full | Impact of the DRG-based reimbursement system on patient care and professional practise: perspectives of Swiss hospital physicians |
| title_fullStr | Impact of the DRG-based reimbursement system on patient care and professional practise: perspectives of Swiss hospital physicians |
| title_full_unstemmed | Impact of the DRG-based reimbursement system on patient care and professional practise: perspectives of Swiss hospital physicians |
| title_short | Impact of the DRG-based reimbursement system on patient care and professional practise: perspectives of Swiss hospital physicians |
| title_sort | impact of the drg based reimbursement system on patient care and professional practise perspectives of swiss hospital physicians |
| topic | Switzerland questionnaire ethics survey DRGs cost-containment |
| url | https://www.smw.ch/index.php/smw/article/view/2010 |
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