Study of cost by type of diagnosis in Switzerland.

Lengths of stay, for a given diagnosis, are poorly correlated between Switzerland, the USA., and Australia; and between 5 hospitals within Switzerland. Three different sets of DRG cost weightings (U.S., French A, French B) are also poorly correlated. Hospital operating efficiencies, standardized by DRG, were estimated and compared. The three sets of cost weightings used all yielded very similar estimates of hospital operating efficiency. The use of current existing systems of cost weightings may, therefore, provide a rapid and cheap means of comparing hospital operating efficiency. In the long run, more precise and detailed cost data will enable national cost weightings to be obtained. Associated issues, such as costing methodologies and perspectives on utilization, are also discussed.