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Policy, Politics, & Nursing Practice
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Adjusting for Nursing Care Case Mix in Hospital Reimbursement

A Review of International Practice

Nancy Laport, MScA

University Hospital of Liège, Belgium

Walter Sermeus, PhD, FEANS, RN

Catholic University Leuven, Belgium

Guy Vanden Boer, MSc, RN

Catholic University Leuven, Belgium

Pieter Van Herck, MSc, RN

Catholic University Leuven, Belgium, Pieter.vanherck{at}med.kuleuven.be

The purpose of this study was to examine and review the different ways in which nursing care can be accounted for in a general hospital reimbursement system. The study is based on a literature review and a survey of international experts. It provides a typology of nursing care adjustment methods, using current and past practices of 14 Western countries as key examples. The results of our review indicate that it is necessary to take the variability of nursing care within DRGs into account, not from a cost-accounting perspective, but from a management perspective in terms of correct resource allocation. However, further investigation of these complex relationships is urgently needed.

Key Words: nursing • hospital • cost • reimbursement mechanism • diagnosis-related groups • case mix

This version was published on May 1, 2008

Policy, Politics, & Nursing Practice, Vol. 9, No. 2, 94-102 (2008)
DOI: 10.1177/1527154408319696
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