New article: A scoping review of empirical evidence on the impacts of the DRG introduction in Germany and Switzerland

Insa Koné, Bettina Maria Zimmermann, Karin Nordström, Bernice Simone Elger, Tenzin Wangmo

Published 13. November 2018

The International Journal of Health Planning and Management



Germany and Switzerland have introduced diagnosis‐related groups (DRGs) for hospital reimbursement. This scoping review aims to evaluate if empirical evidence exists on the effect of the DRG introduction.


Medline via PubMed, Embase (Elsevier), CINAHL, PsychINFO, and Psyndex were systematically screened for studies from 2003 onwards using keywords-DRG, prospective payment system, and lump sum-in English, German, and French. Abstracts were screened for alignment with our inclusion criteria and classified as editorial/commentary, review, or empirical study. The full‐text extraction included data on country, study design, collected data, study population, specialty, comparison group, and outcome measures.


Our literature search yielded 1944 references, of which 1405 references were included in the abstract screening after removal of duplicates. 135 articles were relevant to DRG, including 94 editorials/comments/reviews and 41 empirical articles from 36 different samples. The most frequently used outcome parameters were length of stay (12), reimbursement/cost (9), and case numbers (9).


Only a minority of identified articles (30.4%; 41 of 135) presented empirical data. This indicates that discussion on the topic is not totally evidence‐based. The only common trend was a decrease in length of stay.

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