Artikel
Case-Allocation of extensive operations on head and neck within the German DRG-Systems 2004-2007
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Veröffentlicht: | 8. August 2007 |
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Introduction: When the German-DRG-System was implemented there was some doubt whether cases with extensive head and neck surgery were considered properly within the system. Since the Version 2004 of the German-DRG-System significant effort was made to differenciate the structure of DRGs and the case-allocation of these operations. In this paper the development of the German-DRG-System versions 2004 to 2007 was analysed to answer the question whether the changes within the system lead to an improvement of case-allocation.
Method: Cost-Data from 518 prospective documented cases with extensive head and neck surgery from 25 ENT-Departments were compared with data from the German DRG-Institute (InEK). Therefore statistical measures used by InEK were calculated within both samples.
Results: The reduction of variance of Inlier-costs improved between the versions 2004 and 2007 of the German DRG-System about 107.3%. The avarage coefficient of Cost-homogenity rised about 9.7% in the same period. Case-Mix-Index and DRG-revenues were redistributed from less extensive to very extensive operations on head and neck. Hospitals with large numbers of extensive operations benefit from this development.
Conclusion: The appropriate Case-allocation of extensive operations on Head and Neck has been improved during the further development of the German-DRG-System Version 2007. However, further adjustments will be necessary.