A fundamental problem in health economics is the choice of an optimal compensation system for medical services. Various forms of financing offer different incentives. Individual performance remuneration favor an oversupply of services, DRGs may prefer mild cases. An alternative form of remuneration are episode-based DRGs. In order to estimate the impact to the Austrian health care system of these and other alternative forms of remuneration, a simulation model was developed to compare different payment systems. Among other, the model was presented at the Wintersim Conference in Washington, 2013. dwh now integrates the research for the behavior of individuals operating in networks in the COMET K-project DEXHELPP on which dwh is participated essentially.
Payment systems can have great detail including over a thousand different power positions (for example, "ECG at rest"). Episode-based DRGs attach payments depending on the patient’s disease. An agent-based approach has been adopted in order to map this complexity in a simulation model. Patients and providers inside are represented as agents. Agents are able to interact with each other. In CAP DRG model this mainly concerns the contacts of patients with health care providers and service utilization. Parametrizations were derived directly or by statistical methods from a research database with a large number of routine data (inter alia in cooperation with the Institute for WR and statistics of the Vienna University of Technology). As part of the research project the focus was on modeling the patient's behavior concerning regional selection and the selection behavior, based on the service portfolio of the doctors offered in the agent network.