[The effect of diagnosis-related groups on hospital care].
OBJECTIVE
The implementation of Diagnosis Related Groups (DRG's) is intended to lead to a shortening of hospital days. DRG's therefore may endanger the quality of hospital care or cause a transfer of services from inward to ambulatory care. In this study the consequences of two selected DRG's are examined: operations of patients with varicosis and with hernia.


METHODS
A retrospective comparison of 875 patient files in 6 hospitals in Northrhine-Westphalia (NRW) and a follow-up questionnaire to the patients themselves (N = 510).


RESULTS
Between 1995 and 1997 average hospital days have been reduced by 2 days (varicosis) and 1 day (hernia) respectively. However, the standard stay according to an expert commission of the MOH is still exceeded. The shortening of inward care leads to an increase of ambulatory care. Also the patients indicate a worse subjective health status at discharge although this does not carry through the ambulatory phase.


CONCLUSIONS
For the two DRG's examined the reduction of hospital services due to shorter inward periods is mostly compensated during ambulatory care. An additional shortening of hospital days, however, is likely to lead to negative effects on the health status of patients.
Laaser
U
U
Fakultät für Gesundheitswissenschaften, Universität Bielefeld. u.laaser@health.ibs.uni-bielefeld.de
Röttger-Liepmann
B
B
Breckenkamp
J
J
Bublitz
K
K
D003953:Diagnosis-Related Groups / Q000145:classification / Q000592:standards; D005858:Germany; D006302:Health Services Research; D006304:Health Status; D006547:Hernia / Q000175:diagnosis; D059685:Herniorrhaphy; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D012189:Retrospective Studies; D014648:Varicose Veins / Q000175:diagnosis / Q000601:surgery*