title: Correlation between severity of disease and reimbursement of costs in neonatal and paediatric intensive care patients.
abstract: OBJECTIVE
  The aim of the present study was to investigate the correlation between neonatal, paediatric and adult disease severity scores and reimbursement by health insurances.
  
  
  METHODS
  The setting was a university hospital's neonatal intensive care unit (NICU) and paediatric intensive care unit (PICU). We performed a prospective study of all patients admitted over the 3-month study period. Data collected included five scoring systems to predict mortality or to quantify disease severity (Paediatric Index of Mortality [PIM], Paediatric Risk of Mortality [PRISM], Simplified Acute Physiological Score [SAPS], Score for Neonatal Acute Physiology [SNAP], Therapeutic Intervention Scoring System [TISS]) on a daily basis, the total reimbursement as calculated by the grouper according to the German diagnosis-related groups (DRG) system, age of the patient, length of stay (LOS), International Classification of Diseases (ICD)-10 and DRG diagnosis. Our intention was to determine the correlation between different neonatal, paediatric and adult scores (PIM, PRISM III, SAPS-II, SNAP, Core-10-TISS), and reimbursement by the health insurance on the basis of the German DRG system in its 2005 and 2007 version.
  
  
  RESULTS
  No positive correlation between any score applied and reimbursement by the health insurance could be identified. Reimbursement was positively correlated to the length of hospital stay. Positive correlations could also be shown for some of the scores among each other.
  
  
  CONCLUSIONS
  We conclude that other scoring systems or measures of disease severity urgently need to be established to terminate the chronic underfunding of paediatric intensive care medicine in the developed countries.
authors.affiliation: Department of General Pediatrics, Heinrich-Heine-University, Duesseldorf, Germany. Thomas.hoehn@uni-duesseldorf.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Hoehn
authors.forename: Attyla
authors.initials: A
authors.lastname: Drabik
authors.forename: Christian
authors.initials: C
authors.lastname: Lehmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Christaras
authors.forename: Hans
authors.initials: H
authors.lastname: Stannigel
authors.forename: Ertan
authors.initials: E
authors.lastname: Mayatepek
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D007363:Intensive Care Units, Neonatal / Q000191:economics*; D015278:Intensive Care Units, Pediatric / Q000191:economics; D007902:Length of Stay; D008297:Male; D015997:Neonatal Screening; D011446:Prospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric