Infrastructuring for Quality

Reimbursement and budgeting constitutes a central infrastructural element in most secondary healthcare sectors. In Denmark, Diagnose-Related Groups (DRG) function as the core element for budgeting and encouraging increase in activity and effectivity. However, DRG is known to potentially have adverse effects by encouraging hospitals to maximize reimbursement at the expense of patients. To counter this, one Danish region has initiated an experiment involving nine hospital departments whose normal budgeting and reimbursement based on DRG is put on hold. Instead, they have been asked to develop indicators for quality in treatment to guide and govern their performance, in order to investigate whether this may generate a new performance measurement infrastructure that will improve quality of healthcare. The project is entitled: “New governance in the patient’s perspective”.