Friedrich Keun and Roswitha Prott systematically introduce hospital cost accounting. They link general principles with hospital-specific issues. The concrete effects of the currently applicable payment systems are analyzed in detail. Special attention is given to the mandatory DRG payment system, particularly concerning the flat-rate agreement of 2008 along with the DRG and payment catalogs for that year. The 7th edition includes the GKV Competition Strengthening Act from March 2007 and the potential regulatory frameworks following the 2009 convergence phase. Due to the legal framework in the healthcare sector, there is still a transformation in accounting within hospitals. Specifically, cost and performance accounting is becoming increasingly important as a management tool.