Hospital financing in in-patient psychiatry via DRG-based prospective payment - The Salzburg experience

Hospital financing via case-related prospective payment sometimes is suspec ted to be responsible for accelerating the "revolving-door"-phenomenon in p sychiatry. According to this reasoning, stablishing diagnoses-related group s (DRGs) ruling a prospective payment system could not only reduce lengths of stay but could also simultaneously raise hospitalization and readmission rates. This study analyses the Austrian experience after the implementatio n of such a payment system,the "performance-oriented financing of hospitals " (leistungsorientierte Krankenanstalten-Finanzierung, LKF) in 1997. Time s eries analyses based on the complete hospital discharge statistics of the S alzburg province were used as methods. Results showed that neither length o f stay, nor hospitalization or readmission rates in psychiatry have substan cially changed or deviated from their long-term trends after implementation of the LKF system. Other medical disciplines have experienced statisticall y significant changes. The possibility to transfer these results to the Ger man psychiatric health care system is discussed.