First assessment of T2A on the variability of hospital costs.

Summary This paper studies the variability of hospital costs for stays comparable in pathologies and procedures (GHM). At the time of the global budget, a strong variability of costs was observed between French public hospitals. What is the situation today? In theory, T2A leads hospitals to minimize their costs in order to earn the difference between the fixed price and the cost. We show a certain homogenization of costs and a real consideration of the heterogeneity of individuals. However, the GHM packages do not capture all the heterogeneity between establishments, nor between patients. Thus, the harmful effects of patient selection or a reduction in the level of quality are not avoided by the current packages.