Impact of inpatient reimbursement systems on hospital performance: The Austrian case-based payment strategy

Abstract

Due to cost-intensive technological advances in high-end medicine and increased life expectancy accompanied by a rising number of multi-morbid elderly people, the health care sector consumes a large part of the gross national product of Austria. As the hospital sector is the main contributor to this increasingly unaffordable cost explosion, reimbursement systems for inpatients world-wide have been undergoing massive restructuring. Case-based systems such as the Austrian performance-oriented LKF-system have been introduced to curb the cost explosion. While macro-perspective studies analyze the efficiency of hospitals based on aggregated input and output data using DEA techniques, micro-perspective studies focus on the main incentives of the LKF-system on several outcome measures using empirical data on inpatients with certain major diseases. This study illustrates its impact on hospitals’ performance as well as on the hospitals’ management subsystem of strategic technology management. Such studies support health regulators in improving their reimbursement schemes by closing loopholes.