title: Hospital financing: calculating inpatient capital costs in Germany with a comparative view on operating costs and the English costing scheme.
abstract: OBJECTIVE
  The paper analyzes the German inpatient capital costing scheme by assessing its cost module calculation. The costing scheme represents the first separated national calculation of performance-oriented capital cost lump sums per DRG.
  
  
  METHODS
  The three steps in the costing scheme are reviewed and assessed: (1) accrual of capital costs; (2) cost-center and cost category accounting; (3) data processing for capital cost modules. The assessment of each step is based on its level of transparency and efficiency. A comparative view on operating costing and the English costing scheme is given.
  
  
  RESULTS
  Advantages of the scheme are low participation hurdles, low calculation effort for G-DRG calculation participants, highly differentiated cost-center/cost category separation, and advanced patient-based resource allocation. The exclusion of relevant capital costs, nontransparent resource allocation, and unclear capital cost modules, limit the managerial relevance and transparency of the capital costing scheme.
  
  
  CONCLUSIONS
  The scheme generates the technical premises for a change from dual financing by insurances (operating costs) and state (capital costs) to a single financing source. The new capital costing scheme will intensify the discussion on how to solve the current investment backlog in Germany and can assist regulators in other countries with the introduction of accurate capital costing.
authors: Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Munich, Germany; Ludwig-Maximilians-Universität München, Munich School of Management, Institute of Health Economics and Health Care Management & Munich Center of Health Sciences, Munich, Germany. Electronic address: matthias.vogl@helmholtz-muenchen.de.
authors: Matthias
authors: M
authors: Vogl
mesh_terms: D002202:Capital Financing / Q000191:economics / Q000458:organization & administration; D003953:Diagnosis-Related Groups / Q000191:economics / Q000458:organization & administration; D004469:Economics, Hospital / Q000458:organization & administration; D005377:Financial Management, Hospital / Q000379:methods* / Q000458:organization & administration; D005858:Germany; D017721:Hospital Costs / Q000458:organization & administration*; D006801:Humans; D040841:Resource Allocation / Q000191:economics / Q000458:organization & administration; D006113:United Kingdom
keywords: Capital costs; Cost accounting; Hospital financing; Hospital reimbursement; Resource allocation