title: DRG systems in Europe: variations in cost accounting systems among 12 countries.
abstract: BACKGROUND
  Diagnosis-related group (DRG)-based hospital payment systems have gradually become the principal means of reimbursing hospitals in many European countries. Owing to the absence or inaccuracy of costs related to DRGs, these countries have started to routinely collect cost accounting data. The aim of the present article was to compare the cost accounting systems of 12 European countries.
  
  
  METHODS
  A standardized questionnaire was developed to guide comprehensive cost accounting system descriptions for each of the 12 participating countries.
  
  
  RESULTS
  The cost accounting systems of European countries vary widely by the share of hospital costs reimbursed through DRG payment, the presence of mandatory cost accounting and/or costing guidelines, the share of cost collecting hospitals, costing methods and data checks on reported cost data. Each of these aspects entails a trade-off between accuracy of the cost data and feasibility constraints.
  
  
  CONCLUSIONS
  Although a 'best' cost accounting system does not exist, our cross-country comparison gives insight into international differences and may help regulatory authorities and hospital managers to identify and improve areas of weakness in their cost accounting systems. Moreover, it may help health policymakers to underpin the development of a cost accounting system.
authors.affiliation: 1 Institute for Medical Technology Assessment, Erasmus Universiteit Rotterdam, Rotterdam, the Netherlands tan@bmg.eur.nl.
authors.forename: Siok Swan
authors.initials: SS
authors.lastname: Tan
authors.affiliation: 2 Department of Health Care Management, Berlin University of Technology, Berlin, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Geissler
authors.affiliation: 3 National Board of Health and Welfare, Stockholm, Sweden.
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Serdén
authors.affiliation: 3 National Board of Health and Welfare, Stockholm, Sweden.
authors.forename: Mona
authors.initials: M
authors.lastname: Heurgren
authors.affiliation: 1 Institute for Medical Technology Assessment, Erasmus Universiteit Rotterdam, Rotterdam, the Netherlands.
authors.forename: B Martin
authors.initials: BM
authors.lastname: van Ineveld
authors.affiliation: 1 Institute for Medical Technology Assessment, Erasmus Universiteit Rotterdam, Rotterdam, the Netherlands.
authors.forename: W Ken
authors.initials: WK
authors.lastname: Redekop
authors.forename: Leona
authors.initials: L
authors.lastname: Hakkaart-van Roijen
mesh_terms: D003953:Diagnosis-Related Groups / Q000191:economics*; D004469:Economics, Hospital / Q000706:statistics & numerical data*; D005060:Europe; D006801:Humans; D011795:Surveys and Questionnaires