Patient costs in German hospitals has until recently been calculated mainly by the length of hospital stay. However, in December 1999 the Gesundheitsreform 2000 announced a dramatic change in the social laws. Starting in 2003 a prospective payment system will be introduced based on the classification of the Australian refined diagnosis-related groups (AR-DRG). DRGs are already used in many industrialized countries and are basically per case payment systems by group patients with homogeneous average costs based on the diagnoses and procedures performed in the hospital. When preparing for this new system, the clinician has substantial additional tasks. In addition to correctly documenting all clinical findings by the ICD-10 diagnoses and the German OPS301 procedure codes, a knowledge of the economic impact of the clinical decision is absolutely crucial. The most important task is the optimization of all clinical treatment procedures (e.g., through the introduction of clinical pathways), because only hospitals that can carry out highly efficient treatment will be able to survive the pending competitive climate. In the Mnchen-Schwabing Hospital DRGs have been used as a benchmark since 1997. Many direct measures to optimize efficiency have been taken that are based on valuable experience. Especially in the case of multiple trauma patients it became evident that the use of efficient and standardized treatment can bring economic gain without loss of quality