DRGs: evaluating the experience
It is usually said that anything that originates in the U.S. takes about 5 years to reach the European coast. Certainly the waves set up around the diagnosis-related groups scheme of describing case mix have washed up on our shores. Whether they have taken the polar route to Norway or the more obvious transatlantic route to Portugal, they are here in Europe. In the U.S. there was a development period of 12-15 years before the DRG scheme became a part of the method of payment for nearly half the hospital expenditure in the U.S. in 1983. It could therefore be argued that the scheme has arrived a little early and should really be expected in October 1988. One only has to look at conference programmes in the fields of medical informatics, hospital finance and budgeting, health economics, health service management, hospital information and computer systems to realise that DRGs are being talked about. Not only are they frequently to be found in such programmes, but DRGs have been the subject of much back-room research, analysis and initial experimentation outside the U.S. for some years. In order to review both what had happened to the U.S. health market and to draw together the growing body of expertise outside the U.S., the European Health Policy Forum took up the subject in its recent conference “DRGs evaluating the experience”. The conference was the 15th joint WHO/EHPF meeting, held in Brussels on 141.5 October 1987. The event was planned to follow-on from a twoday WHO technical working meeting, and receive a report of the discussions in the first meeting. Since DRGs are, or at least appear to many people to be a complex subject, the conference organisers wisely chose to keep the presentations away from technical detail and most speakers concentrated on an evaluative approach to their subject. This was also partly because those attending the WHO meeting, and who moved en bloc to the joint conference, had already had the opportunity over the previous two days to discuss the subject in more detail.