title: [Analysis of personnel costs after reorganization of intensive care using calculated diagnosis-related groups comparative data. An investigation at the Charité Berlin].
abstract: BACKGROUND
  In an extensive project intensive care units (ICUs) of the Charité University Hospital were reorganized. The aim of this investigation was to determine if staff costs after this reorganization are financed by modular profits of diagnosis-related groups (DRGs).
  
  
  METHODS
  Staff costs of all non-pediatric intensive care units, including ICUs, intermediate care units and post-anaesthesia care units (PACUs) in the Charité University Hospital were compared with the modular profits of all DRGs of patients older than 14 years in 2005. These DRGs were converted into the German refined DRG (GDRG) system 4.0 from 2006 with calculations based on actual income for medical doctors and nurses in 2006. Due to changed wage agreements for the incomes of physicians in 2006 there was an increase of costs. For the other professional groups an increase in income is expected, which cannot be estimated at present.
  
  
  RESULTS
  The calculation revealed that staff costs of the ICUs at the Charité University Hospital based on a current German mean base rate of 2,836 EUR were 4.2% above the modular profits of the DRGs. As a result of a structural reorganization of the ICUs, the costs of staff could be adapted to the modular profits. Under the conditions of the actual reduced base rate of Berlin of 2,955 EUR the costs and profits were nearly equal. As the financial impact of the reorganization of the ICUs will take full effect in the coming years, it can be anticipated that with an expected base rate of 2,949 EUR in 2010 the intensive care medicine of a University hospital in Germany can become profitable.
  
  
  CONCLUSIONS
  The spectrum of intensive care medicine at the Charité University Hospital covers the maximum range of operative and non-operative medicine. After an extensive reorganization of the ICUs under the aspect of staff costs, intensive care medicine can become profitable under the 4.0 G-DRG system. With consequent reorganization the cost efficiency of staff can be optimized, particularly in the setting of high-end intensive care medicine.
authors.affiliation: Klinik für Anästhesiologie und operative Intensivmedizin, Campus Charité Mitte und Campus Virchow-Klinikum, Charitéplatz 1, 10117 Berlin. jan.braun@charite.de
authors.forename: J P
authors.initials: JP
authors.lastname: Braun
authors.forename: B
authors.initials: B
authors.lastname: Schwilk
authors.forename: L
authors.initials: L
authors.lastname: Kuntz
authors.forename: M
authors.initials: M
authors.lastname: Kastrup
authors.forename: U
authors.initials: U
authors.lastname: Frei
authors.forename: D
authors.initials: D
authors.lastname: Schmidt
authors.forename: B
authors.initials: B
authors.lastname: Behrends
authors.forename: A
authors.initials: A
authors.lastname: Schleppers
authors.forename: U
authors.initials: U
authors.lastname: Kaisers
authors.forename: C
authors.initials: C
authors.lastname: Spies
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003365:Costs and Cost Analysis; D003953:Diagnosis-Related Groups; D005858:Germany; D006801:Humans; D007182:Income; D007362:Intensive Care Units / Q000191:economics* / Q000458:organization & administration; D008875:Middle Aged; D009726:Nurses; D010564:Personnel, Hospital / Q000191:economics*; D010820:Physicians; D000078329:Workforce