[Diagnostic control. Psychiatric comorbidity in patients of technical orthopedic units].
Because of the new hospital finance law a DRG (Diagnosis Related Groups) controlled discount liquidation under consideration of the medical impairment becomes necessary. In this paper the importance of a correct and complete description of the psychic comorbidity for the development of German-Refined-DRGs (GR-DRGs) in the orthopedic field is described. Therefore we analysed data of orthopedic in-patients, who are diagnosed by consultation of the clinic for psychosomatics and psychotherapy. A psychic comorbidity (ICD-10 Chapter F (V)) was diagnosed by 95% of the consulted patient. 30% of the patients showed difficulties in coping with their disease. 40% suffered from chronical psychoneurotic patterns and conflicts, which can be explained (a) as consequence of a difficult psychosocial adaptation by chronic disease or after an amputation (b) as basic mental disorders (c) as cause of the orthopaedic complications. Therefore the number of indications for a psychotherapeutic or psychiatric treatment is very high. The knowledge about a psychic comorbidity can--beside financial aspects--help the team on the orthopaedic station in the treatment of difficult patient.
Lange
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Klinik und Poliklinik für Psychosomatik und Psychotherapie, Universitätsklinikum Münster, Domagkstrasse 22, 48129 Münster. langeco@medsnt01.uni-muenster.de
Heuft
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Wetz
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D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000523:psychology; D015897:Comorbidity; D003953:Diagnosis-Related Groups / Q000191:economics; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000191:economics / Q000523:psychology*; D010348:Patient Care Team / Q000191:economics; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000191:economics / Q000523:psychology; D011613:Psychotherapy / Q000191:economics; D012017:Referral and Consultation / Q000191:economics; D012307:Risk Factors; D012803:Sick Role; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000191:economics / Q000523:psychology