[Implementation of the public health reform law--experiences with diagnosis related case payment in surgery].
According to new German health care laws (Gesundheitsstrukturgesetz, Bundespflegesatzverordnung) hospital payment will be given a new basis. Abandoning the "length of stay"--related compensation in the future surgical services should be refunded either by special payments for a given surgical procedure (covering anesthesia, surgery, instruments), or by case-related payments (including all costs of stay, medical as well as room-and-care and administrative). This should lead to a more equitable payment getting a transparent insight into the relation service/cost. Calculations for the so far 103 special payment and 40 case related payment items have been obtained by a nationwide analysis in reference hospitals. Besides numerous problems introducing these new refund systems in very different hospital structures, our own 3-year experience using case related payment on our surgical department (based on individual calculation) shows promising results. The main intention still has to be--by setting free economic resources--to avoid rationing though rationalization.
Bauer
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Chirurgische Abteilung, Kreiskrankenhaus Alt/Neuötting, Altötting.
D003363:Cost Control / Q000331:legislation & jurisprudence; D003953:Diagnosis-Related Groups / Q000191:economics / Q000331:legislation & jurisprudence*; D004469:Economics, Hospital / Q000331:legislation & jurisprudence*; D005245:Fee Schedules / Q000331:legislation & jurisprudence; D013502:General Surgery / Q000331:legislation & jurisprudence*; D005858:Germany; D018166:Health Care Reform / Q000191:economics / Q000331:legislation & jurisprudence*; D017721:Hospital Costs / Q000331:legislation & jurisprudence; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000331:legislation & jurisprudence; D008329:Managed Care Programs / Q000191:economics / Q000331:legislation & jurisprudence; D009313:National Health Programs / Q000191:economics / Q000331:legislation & jurisprudence*
Zur Umsetzung des Gesundheitsstrukturgesetzes--Erfahrungen mit diagnosebezogenen Fallpauschalen in der Chirurgie.