Has the DRG system impacted on inpatient allergy care in university dermatology departments in Germany?
BACKGROUND
Diagnostic provocation tests (ICD Z01.5) have a low cost weight in the German DRG system. We aimed at investigating a possible economic impact on the number of provocation tests in German university medical centers (UMC) for dermatology.


METHODS
We review quality records of 35 German UMC for 2008 and 2010 (ICD Z01.5, total number of patients as well as priority ranking).


RESULTS
33/35 hospitals gave full data for both years including the ten most frequent diagnoses. Between 2008 and 2010, total number of patients treated increased in 23/33 (70 %) UMC, those with ICD Z01.5 only in 11/24 (46 %) UMC with full data. In 2008, the ICD Z01.5 was in the top ten list of main diagnoses in 29/33 (88 %) hospitals, in 2010 in 25/33 (76 %); also, priority ranking tended to decrease. In contrast, total number of ICD Z01.5 in Germany tended to increase slightly.


CONCLUSIONS
We noticed a tendency for decreasing numbers of provocation tests being performed in dermatological UMC in Germany. As there is no evidence for a decreasing number of patients suffering from allergies, one may speculate about a shift to non-university departments due to an economic impact.
Department of Dermatology, Venereology and Allergology, University of Leipzig, Germany Chair for Health Management, Germany. regina.treudler@uniklinik-leipzig.de
Regina
R
Treudler
Florian
F
Meier
Oliver
O
Schöffski
Jan-Christoph
JC
Simon
D000046:Academic Medical Centers; D003880:Dermatology / Q000191:economics / Q000706:statistics & numerical data*; D003953:Diagnosis-Related Groups / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000191:economics* / Q000453:epidemiology; D015994:Incidence; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000706:statistics & numerical data; D012882:Skin Tests / Q000191:economics / Q000706:statistics & numerical data*