Details
Translated title of the contribution | G-DRG reimbursement for polytrauma patients - A comparison with the comprehensive hospital costs using the german trauma registry |
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Original language | German |
Pages (from-to) | 68-75 |
Number of pages | 8 |
Journal | UNFALLCHIRURG |
Volume | 107 |
Issue number | 1 |
Early online date | 18 Dec 2003 |
Publication status | Published - Jan 2004 |
Abstract
The introduction of diagnosis related groups (DRG) will radically change the payment system for german hospitals. In 2002 the values for most DRG's were published for the german system (G-DRG). The polytrauma working group of the German Trauma Society developed a calculating algorithm to estimate the comprehensive hospital costs for every patient in the german trauma registry. The aim of this study was to compare these costs with the reimbursement according the the G-DRG's for a standardized population of polytrauma patients. Material and Methods. For polytrauma patients treated at Hannover Medical School in 2000 and 2001 the reimbursement according to the G-DRG's was calculated using a base value of 2900 EUR. In the same patients the total cost of inpatient treatment was calculated according to the algorithm developed by the polytrauma working group of the German Trauma Society. The difference between these values represents the economic result. This was calculated as an overall result, but also for specific subgroups of patients (injury severity, mortality, G-DRG grouping). Results. Datasets of 103 polytrauma patients were included. The following G-DRG's were most frequently occuring: A06Z (n=41), A07Z (n=16), W01Z (n=13). All other G-DRG's were documented less than 3 times. The mean reimbursement according to the G-DRG was 21.380±12.300 EUR for a polytrauma patient. However, the mean hospital cost accounted to 34.274±22.501 EUR, which resulted in a mean deficit of 12.893±15.534 EUR. Analysis of subgroups revealed, that an ISS of more than 35 points, patients with a prolonged hospital stay and patients of the G-DRG group A06Z show a particularly negative result. Conclusion. The comprehensive hospital costs for treating polytrauma patients are on average 12.893 EUR higher than the reimbursement according the G-DRG's. For hospitals to be fully reimbursed G-DRG values have to be reconfigured according to the german health care system. Thus, inclusion criteria to specific G-DRG have to be changed and a specific G-DRG group for very severely injured patients needs to be established.
ASJC Scopus subject areas
- Medicine(all)
- Surgery
- Medicine(all)
- Emergency Medicine
- Medicine(all)
- Orthopedics and Sports Medicine
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In: UNFALLCHIRURG, Vol. 107, No. 1, 01.2004, p. 68-75.
Research output: Contribution to journal › Review article › Research › peer review
}
TY - JOUR
T1 - DRG-Entlohnung beim Polytrauma
T2 - Ein Vergleich mit den tatsächlichen Krankenhauskosten anhand des DGU-Traumaregisters
AU - Grotz, M.
AU - Schwermann, T.
AU - Lefering, R.
AU - Ruchholtz, S.
AU - Schulenburg, J. M.Graf V.D.
AU - Krettek, C.
AU - Pape, H. C.
PY - 2004/1
Y1 - 2004/1
N2 - The introduction of diagnosis related groups (DRG) will radically change the payment system for german hospitals. In 2002 the values for most DRG's were published for the german system (G-DRG). The polytrauma working group of the German Trauma Society developed a calculating algorithm to estimate the comprehensive hospital costs for every patient in the german trauma registry. The aim of this study was to compare these costs with the reimbursement according the the G-DRG's for a standardized population of polytrauma patients. Material and Methods. For polytrauma patients treated at Hannover Medical School in 2000 and 2001 the reimbursement according to the G-DRG's was calculated using a base value of 2900 EUR. In the same patients the total cost of inpatient treatment was calculated according to the algorithm developed by the polytrauma working group of the German Trauma Society. The difference between these values represents the economic result. This was calculated as an overall result, but also for specific subgroups of patients (injury severity, mortality, G-DRG grouping). Results. Datasets of 103 polytrauma patients were included. The following G-DRG's were most frequently occuring: A06Z (n=41), A07Z (n=16), W01Z (n=13). All other G-DRG's were documented less than 3 times. The mean reimbursement according to the G-DRG was 21.380±12.300 EUR for a polytrauma patient. However, the mean hospital cost accounted to 34.274±22.501 EUR, which resulted in a mean deficit of 12.893±15.534 EUR. Analysis of subgroups revealed, that an ISS of more than 35 points, patients with a prolonged hospital stay and patients of the G-DRG group A06Z show a particularly negative result. Conclusion. The comprehensive hospital costs for treating polytrauma patients are on average 12.893 EUR higher than the reimbursement according the G-DRG's. For hospitals to be fully reimbursed G-DRG values have to be reconfigured according to the german health care system. Thus, inclusion criteria to specific G-DRG have to be changed and a specific G-DRG group for very severely injured patients needs to be established.
AB - The introduction of diagnosis related groups (DRG) will radically change the payment system for german hospitals. In 2002 the values for most DRG's were published for the german system (G-DRG). The polytrauma working group of the German Trauma Society developed a calculating algorithm to estimate the comprehensive hospital costs for every patient in the german trauma registry. The aim of this study was to compare these costs with the reimbursement according the the G-DRG's for a standardized population of polytrauma patients. Material and Methods. For polytrauma patients treated at Hannover Medical School in 2000 and 2001 the reimbursement according to the G-DRG's was calculated using a base value of 2900 EUR. In the same patients the total cost of inpatient treatment was calculated according to the algorithm developed by the polytrauma working group of the German Trauma Society. The difference between these values represents the economic result. This was calculated as an overall result, but also for specific subgroups of patients (injury severity, mortality, G-DRG grouping). Results. Datasets of 103 polytrauma patients were included. The following G-DRG's were most frequently occuring: A06Z (n=41), A07Z (n=16), W01Z (n=13). All other G-DRG's were documented less than 3 times. The mean reimbursement according to the G-DRG was 21.380±12.300 EUR for a polytrauma patient. However, the mean hospital cost accounted to 34.274±22.501 EUR, which resulted in a mean deficit of 12.893±15.534 EUR. Analysis of subgroups revealed, that an ISS of more than 35 points, patients with a prolonged hospital stay and patients of the G-DRG group A06Z show a particularly negative result. Conclusion. The comprehensive hospital costs for treating polytrauma patients are on average 12.893 EUR higher than the reimbursement according the G-DRG's. For hospitals to be fully reimbursed G-DRG values have to be reconfigured according to the german health care system. Thus, inclusion criteria to specific G-DRG have to be changed and a specific G-DRG group for very severely injured patients needs to be established.
KW - Diagnosis related groups
KW - Hospital costs
KW - Hospital reimbursement
KW - Polytrauma
KW - Trauma registry
UR - http://www.scopus.com/inward/record.url?scp=0842313034&partnerID=8YFLogxK
U2 - 10.1007/s00113-003-0715-5
DO - 10.1007/s00113-003-0715-5
M3 - Übersichtsarbeit
C2 - 14749855
AN - SCOPUS:0842313034
VL - 107
SP - 68
EP - 75
JO - UNFALLCHIRURG
JF - UNFALLCHIRURG
SN - 0177-5537
IS - 1
ER -