Casemix-based hospital financing systems are now spreading all over European Countries.
Started for the first time in 1966 in the USA because of a concern about the abuse of payment stemming from the Medicare implementation the concept jumped across the Atlantic Ocean and was called PMSI in 1981 in France. The pitfall of such patients classification systems consists in the possibility of manipulating the coding. So physician advisers have to be suspicious when a trend is uncovered without any other epidemiological explanation.
Related reports and articles:
CONFERENCE ON EUROPEAN CASEMIX-BASED
HOSPITAL PROSPECTIVE PAYMENT SYSTEMS: actes_uk
Changes in diagnostic coding may affect data that indicate decline in pneumonia hospitalizations: