[Insufficient funding of nursing service in paediatrics. The case of the DRG E77C].
For most of the existing German Diagnosis Related Groups (G-DRG) the German generalised compensation system for medical services in hospitals does not distinguish between children and adults. There is a risk of the cost of high-maintenance paediatric patients not being covered. This problem is tried to be solved by implementing a split based on the patient's age. Thus children under the age of one year will be classified to a different DRG than older patients with the same diagnosis. A study of working time combined with an analysis of the so-called "Pflegepersonalregelung-Minuten" carried out by the Ernst-Moritz-Arndt University of Greifswald exemplarily shows the different intenseness of care between paediatric and adult patients. Furthermore, the different intenseness of care correlates with the labour cost of the university hospital and shows the extensions of the shortfall for the most profitable DRG based on guidelines of the "Institut für das Entgeltsystem im Krankenhaus" (Institute for the compensation system in hospitals, InEK). Last but not least it discusses if the age-splitting planned for the 2008 DRG-Catalogue might improve the financial situation. Moreover the authors point out possibilities for a proper compensation for paediatrics in the G-DRG system.
Herrmann
René
R
Sana Kliniken AG, Lübeck. rene.herrmann@sana.de
Fusch
Christoph
C
Flessa
Steffen
S
D000328:Adult; D002648:Child; D003953:Diagnosis-Related Groups / Q000145:classification / Q000191:economics*; D005858:Germany; D006801:Humans; D007355:Insurance, Nursing Services / Q000191:economics*; D009313:National Health Programs / Q000191:economics*; D010371:Pediatric Nursing / Q000191:economics*; D012051:Reimbursement Mechanisms / Q000191:economics*; D013996:Time and Motion Studies