title: [The German DRG system 2003-2010 from the perspective of intensive care medicine].
abstract: BACKGROUND
  Intensive care medicine is extremely heterogeneous, expensive and can only be partially planned and controlled. A correct and fair representation of intensive care medicine in the G-DRG system is an essential requirement for the use as a pricing system. From the perspective of intensive care medicine, pertinent changes of the DRG structure and differentiation of relevant parameters have been established within the G-DRG systems 2003-2010.
  
  
  METHODS
  Analysis of relevant diagnoses, medical procedures, co-payment structures and G-DRGs in the versions 2003-2010 based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI).
  
  
  RESULTS
  Since the first G-DRG system version 2003, numerous measures improved quality of case allocation of intensive care medicine. Highly relevant to the system version 2010 are duration of mechanical ventilation, the intensive care treatment complex and complicating constellations. The number of G-DRGs relevant to intensive medical care increased from n = 3 (2003) to n = 58 (2010).
  
  
  CONCLUSIONS
  For standard cases, quality of case allocation and G-DRG reimbursement are adequate in 2010. The G-DRG system gained complexity again. High demands are made on correct and complete coding of complex cases. Nevertheless, further adjustments of the G-DRG system especially for cases with extremely high costs are necessary. Where the G-DRG system is unable to cover extremely high-cost cases, reimbursement solutions beyond the G-DRG structure should be taken into account.
authors.affiliation: DRG-Research-Group, Universitätsklinikum Münster, Münster, Germany. Dominik.Franz@ukmuenster.de
authors.forename: Dominik
authors.initials: D
authors.lastname: Franz
authors.forename: Holger
authors.initials: H
authors.lastname: Bunzemeier
authors.forename: Norbert
authors.initials: N
authors.lastname: Roeder
authors.forename: Holger
authors.initials: H
authors.lastname: Reinecke
mesh_terms: D003422:Critical Care; D003953:Diagnosis-Related Groups; D005858:Germany; D017048:Health Care Costs; D006801:Humans; D008511:Medicine; D009313:National Health Programs; D009985:Orthopedics; D014194:Traumatology