[Geriatric treatment in hospitals?--medical, legal, and economic aspects].
Multimorbidity and functional impairment in geriatric patients regularly necessitate a combination of acute medical care and functional therapy. In Germany, comprehensive geriatric care is usually provided in hospitals, but also in clinical rehabilitation units. Different payment systems (diagnosis related groups in hospitals, day-to-day charges in rehabilitation centers) have precipitated a discussion on the separation of the acute phase from the rehabilitative phase of the disease with medical issues prevailing in the former and functional training in the latter. In geriatric patients, however, medical treatment of acute and chronic diseases should be continuously combined with functional therapy from the beginning of the hospital stay (i. e. early rehabilitation). Thus, acute hospital treatment followed by rehabilitation in a different institution, a method frequently used with younger patients with single defined diagnoses, has shown to be disadvantageous in geriatric patients. Some federal states in Germany favor the concept of one-step comprehensive hospital care including rehabilitation. As discussed in the article in detail, this procedure is in full accordance with the German social law.
Plute
G
G
Unternehmensbereichsleiter Recht a. D., AOK Niedersachsen, Engerode 15, 30880 Laatzen b. Hannover, Germany. gerhard.plute@t-online.de
Vogel
W
W
D003695:Delivery of Health Care / Q000191:economics / Q000331:legislation & jurisprudence; D003953:Diagnosis-Related Groups / Q000191:economics* / Q000331:legislation & jurisprudence*; D005858:Germany; D006299:Health Services for the Aged / Q000191:economics* / Q000331:legislation & jurisprudence*; D006760:Hospitalization / Q000191:economics* / Q000331:legislation & jurisprudence*