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- Title
Introduction of diagnosis-related groups in Germany: evaluation of impact on in-patient care in a dermatological setting.
- Authors
Hensen, P.; Beissert, S.; Bruckner-Tuderman, L.; Luger, T. A.; Roeder, N.; Müller, M. L.
- Abstract
Background: German diagnosis-related groups (G-DRG) have been introduced in Germany as a reimbursement system for in-patient care. The aim of this study was to report data-based experiences from the introduction process and to evaluate the impact on in-patient dermatology. Methods: A quantitative analysis including clinical data from two large university centres of dermatology over a time period of 4 years (2003-06) has been performed. Characteristics and trends of case-mix index, number of cases, average age, length of stay (LOS), surgical and medical treatments and in-patient case groups were studied in detail. Results: It was found that the case-mix index values increased after the introduction period, but subsequently declined on the initial value. At the same time, an increase of dermatological hospital admissions can be noticed parallel to a significant reduction of LOS (P<0.001) and a moderate increase of average age (P<0.001). Analysis of DRG assignment revealed an initial significant decline of surgical in-patient procedures and increasing medical treatments, however, without obvious long-term changes. Furthermore, a growing importance for dermatological ontology and inflammable skin diseases within the in-patient setting could be observed. Conclusions: The introduction of the G-DRG system in Germany induced changes in in-patient care affecting hospital admission rates, LOS and cases treated in an in-patient setting. In-patient activities have not been reduced with the DRG introduction; however, long-term interdisciplinary research approaches are needed to explore the future impact on health care providing and quality of health care in depth.
- Subjects
GERMANY; HOSPITAL care; INPATIENT care; LENGTH of stay in hospitals; DERMATOLOGY; SKIN diseases
- Publication
European Journal of Public Health, 2008, Vol 18, Issue 1, p85
- ISSN
1101-1262
- Publication type
Article
- DOI
10.1093/eurpub/ckm059