France, with its population of around 62 million, is one of the largest countries in the EU, first by geographic size and second, after Germany, by population. US DRGs were introduced into France as GHM (Groupes Homogène de Malades) as early as 1983, but they weren't used as a resource allocation tool until 1997, and had no major impact until 2004. This project, called PMSI (Programme de Médicalisation des Systèmes d'Information), has been shaped by the fragmented design of the French health care system and by the cultural framework embedding socio-economic reform in France.
A brief description of the French health care system
Ranked the number one health care system in the world by the World Health Organization in 2000, the French health care system provides a high level of service, but at what could be considered a very high price when compared to many other OECD countries.
Hospital care is characterized by the coexistence of public, private for-profit, and private not-for-profit hospitals, whose ownership, organization, management and financing differ widely.
The French population enjoys a good health care status and benefits and easy accessibility (despite geographic inequalities) to the entire health care system. However, the cost of this system, and therefore its tendency to increase deficits, has been a major issue in public debates for over three decades.
Satisfaction with the French health care system is traditionally high – much higher than in most other countries.