The introduction of hospital reimbursement based on diagnosis related groups (DRG) in 2004 has been a conspicuous … attempt to increase hospital efficiency in the German health sector. In this paper changes of hospital efficiency, quantified … of negative spatial spillovers among German hospital performance can be diagnosed. This result is in line with a rise of …

Many OECD countries have replaced per-diem hospital reimbursement with lump sum payments by diagnosis-related groups … the efficiency of health care provision. This paper analyzes hospital responses to a large-scale refinement of … reimbursement practices in Germany on January 1, 2006, in which regulating authorities introduce reimbursements by treatment …