[Diagnosis related groups in stroke treatment. An analysis from the stroke data bank of the German Stroke Foundation].
BACKGROUND
The upcoming introduction of diagnosis related groups (DRG) as an exclusive base for future calculation of hospital proceeds in Germany requires a thorough analysis of cost data for various diseases.


OBJECTIVE
To compare the resulting combined cost weights of the Australian Refined DRG system (AR-DRG) with the proceeds based on actual per-day rates in stroke treatment.


METHODS
Between 1998 and 1999, data from 6520 patients (median age 68 years, 43% women) with acute stroke or transient ischemic attack (TIA) were prospectively documented in 15 departments of Neurology with an acute stroke unit, 9 departments of general Neurology and 6 departments of Internal Medicine. Prior to grouping cases into DRGs, all available data were transferred into ICD-10-SGB-V 2.0 or the Australian procedure system (MBS-Extended). Hospital proceeds for the respective cases were calculated based on per-day rates of the documenting hospitals.


RESULTS
The resulting cost weights demonstrate a good homogeneity compared to the length of stay. When introducing the AR-DRG with a uniform base rate in Germany, a relative decrease of hospital proceeds can be expected in Neurology Departments and for treatment of TIAs.


CONCLUSIONS
Preservation of the existing structure of acute stroke care in Germany requires a supplement to a uniform base rate in Neurology departments.
Weimar
C
C
Neurologische Klinik, Universität Essen. stroke.med@uni-essen.de
Stausberg
J
J
Kraywinkel
K
K
Wagner
M
M
Busse
O
O
Haberl
R L
RL
Diener
H-C
HC
D000208:Acute Disease / Q000191:economics; D000368:Aged; D001315:Australia; D016208:Databases, Factual; D003953:Diagnosis-Related Groups / Q000191:economics*; D005260:Female; D005858:Germany; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D012051:Reimbursement Mechanisms; D012720:Severity of Illness Index; D020521:Stroke / Q000191:economics* / Q000628:therapy*; D016896:Treatment Outcome