gms | German Medical Science

58. Kongress der Deutschen Gesellschaft für Handchirurgie

Deutsche Gesellschaft für Handchirurgie

12. - 14.10.2017, München

How German health care in hand surgery is funded

Meeting Abstract

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  • corresponding author presenting/speaker Ralf Nyszkiewicz - Klinik für Orthopädie, Unfall- und Handchirurgie, Werner Forßmann Krankenhaus, Eberswalde, Germany

Deutsche Gesellschaft für Handchirurgie. 58. Kongress der Deutschen Gesellschaft für Handchirurgie. München, 12.-14.10.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. Doc17dgh033

doi: 10.3205/17dgh033, urn:nbn:de:0183-17dgh0330

Published: October 10, 2017

© 2017 Nyszkiewicz.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives: In Germany the costs for the treatment of patients are mostly refunded by insurance companies. Very few patients do not have a healthcare insurance. In Germany the costs for treatment in hospital are refunded by the G-DRG-System (German-Diagnosis-related-Groups-System). The German-DRG-System has been implemented in 2003. It is a system to classify cases of hospital treatment into economically comparable groups based on medical characteristics. Specific characteristic of the G-DRG-System is that all cases are classified, exceptions are no more made. Furthermore, the German system of Diagnosis Related Groups (G-DRG) shall continue to be examined and further developed as a "learning system". Thanks to the efforts on the part of the self-governing bodies of Germanys health care system, as well as the individual hospitals and their employees, since its launch, the G-DRG-System has, all in all, developed from an adapted version of the Australian DRG system into a fee-per-case system in its own right that is tailored to the health care situation in Germany and demonstrates an unparalleled breadth and depth by international comparison.

Method: The author explains the basics of the German DRG-System and the Problems and Pitfalls that concern especially the Hand-Surgery Departments in getting adequate refund for the work done.

Results: Experience has shown that most important for the correct assignment of to a single DRG is the exact coding of diagnoses of the patient and procedures performed during his stay in the hospital. Therefore it has become crucial for the success of every hospital department that this coding is precisely done. In order to represent the work that has been done at an optimum, it is essential to "translate" the medical procedures into procedural codes as exactly as possible. In Germany this "translation" is the surgeons task. This coding-work is rather difficult and very often cause for discussion with insurance companies

Conclusion: The presentation explains the basics of the refunding of hospital care in Germany and the special difficulties concerning the reimbursement of costs for hospital treatment of hand-surgery patients in Germany.