title: [Development of diagnosis-related groups in different surgical disciplines].
abstract: BACKGROUND
  Since the introduction of Diagnosis-Re-lat-ed Groups (DRGs) in Germany, the variables of remuneration have continuously changed. Subjectively, reimbursement by DRG has a negative connotation among all specialities. We analysed the development of reimbursement and length of stay in different surgical specialties.
  
  
  METHODS
  By grouping the top-10-diagnoses and therapies in hand surgery, trauma surgery, general surgery as well as cardiothoracic and vascular surgery between 2004 and 2010, DRGs were obtained, compared and the data deduced.
  
  
  RESULTS
  While the lower threshold of length of stay remained almost the same, mean value and upper threshold became shorter in most of the top-10-diagnoses. During the observation period, total reimbursement increased by 30 % in hand surgery, 20 % in general surgery and 17 % in cardiothoracic and vascular surgery, while in trauma surgery it decreased by 1 %. This corresponds to mean annual growth rates of 4.47 %, 3.08 %, 2.68 % and - 0.15 %, respectively. No correlation was found between the 4 disciplines and macro-economic parameters.
  
  
  CONCLUSIONS
  Reductions of mean and upper thresholds of length of stay are present in all surgical disciplines. Total reimbursements developed partially in a contradictory manner. Negative growth involves the danger that hospital investments cannot be realised, especially in the presence of high personnel costs.
authors.affiliation: Klinik für Plastische, Hand-, Rekonstruktive und Verbrennungschirurgie an der Eberhard Karls Universität Tübingen, BG Unfallklinik, Tübingen, Deutschland.
authors.forename: O
authors.initials: O
authors.lastname: Lotter
authors.affiliation: Klinik für Plastische, Hand-, Rekonstruktive und Verbrennungschirurgie an der Eberhard Karls Universität Tübingen, BG Unfallklinik, Tübingen, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Stahl
authors.affiliation: Universitätsklinik für Allgemeine, Viszeral- und Transplantationschirurgie und Universitätsklinik für Thorax-, Herz- und Gefäßchirurgie an der Eberhard Karls Universität Tübingen, Tübingen, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Beck
authors.affiliation: Klinik für Unfall- und Wiederherstellungschirurgie an der Eberhard Karls Universität Tübingen, BG Unfallklinik, Tübingen, Deutschland.
authors.forename: W
authors.initials: W
authors.lastname: Loewe
authors.affiliation: Klinik für Plastische, Hand-, Rekonstruktive und Verbrennungschirurgie an der Eberhard Karls Universität Tübingen, BG Unfallklinik, Tübingen, Deutschland.
authors.forename: H-E
authors.initials: HE
authors.lastname: Schaller
mesh_terms: D003953:Diagnosis-Related Groups / Q000145:classification* / Q000191:economics / Q000458:organization & administration*; D005858:Germany; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics; D009313:National Health Programs / Q000191:economics*; D012051:Reimbursement Mechanisms / Q000191:economics*; D013043:Specialties, Surgical / Q000191:economics*