Once efficient clinical practice is established through budgeting, DRGs could be calculated according to efficiency criteria rather than current average cost. Data on outcome are crucial to determining efficiency. The failure of more global budgeting in the past has been that patient outcome has not been monitored. Efficient clinical practice is better established through use of less sophisticated techniques, such as clinical budgeting and cost-effectiveness analysis. At this stage, use of DRGs within a system of global budgeting will simply focus attention on the current average costs of treating cases without consideration of whether such average costs represent efficient clinical practice. Effects on patient outcome have not been adequately assessed. Small quantities of fine sediments are also dredged from shallow channels in Western Port as required. This is deposited in a spoil ground 15 km south of Melbourne. ![]() Whether the use of DRGs has substantially reduced hospital cost per case is also not clear cut. The largest volume of fine sediments is dredged from shipping channels, including parts of the Yarra River, in the Port of Melbourne. By controlling only the price of hospital care, such systems remain vulnerable to compensatory increases in patient throughout, cost shifting and patient-shifting. Most forthcoming is the indeterminate effect of DRGs as a funding mechanism. In this paper, the effects of using diagnosis-related groups (DRGs) as the basis of a hospital funding mechanism and within a global budgeting mechanism are reviewed.
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