The PPS is a fixed payment for a particular type of care over a particular time frame. This can be taken as an advantage but even though the system tries to make payments as accurate as possible this is not always achieved. The payments are based on statistical variance, teaching related-costs and other situations. The PPS is based on government regulations; it can be changed at any time, usually according to inflation, availability of new drugs, new technology and different hospital processes. The formula used to calculate the PPS is highly complex, this complexity can bring misunderstandings and misclassification of medical procedures. This formula cannot straightforwardly account for quality or safety as these terms cannot be expressed in
