A new case-mix based payment system for the psychiatric day care sector in Switzerland: proposed methods for developing the tariff structure

Samuel Noll, Sarah Haag, Rémi Guidon and Simon Hölzer

Health Policy, 2023, vol. 131, issue C

Abstract: In many European countries, there has been a shift towards outpatient psychiatric care over the past decades, as it is more cost-effective and resources for health care are limited. Switzerland, however, still has a high number of inpatient psychiatric hospital beds and a comparatively high length of stay. The existence of differing remuneration systems between inpatient and outpatient settings creates a distortion of incentives regarding the choice of treatment setting and an inefficient allocation of resources. To address this issue, a new tariff structure for day care treatment is suggested, based on the development and evaluation of the DRG-based inpatient remuneration system tariff psychiatry (TARPSY), using inpatient data from 2018, 2019, and 2021. The method involves three steps: estimating the day care treatment setting potential by delimiting cases from the inpatient patient data, adjusting the costs of this subset to approximate a day care treatment setting, and calculating daily cost weights based on the existing cost weights. The resulting reimbursements are about half of the inpatient reimbursements.

Keywords: Organisation of psychiatric day-care; Health reform; Governance & health economics; Hospital financing; Tariff structure (search for similar items in EconPapers)
Date: 2023
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Persistent link: https://EconPapers.repec.org/RePEc:eee:hepoli:v:131:y:2023:i:c:s0168851023000829

DOI: 10.1016/j.healthpol.2023.104797

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