title: [Ten years of early complex geriatric rehabilitation therapy in the DRG system].
abstract: BACKGROUND
  Geriatric medicine, as a specialized form of treatment for the elderly, is gaining in importance due to demographic changes. Especially important for geriatric medicine is combining acute care with the need to maintain functionality and participation. This includes prevention of dependency on structured care or chronic disability and handicap by means of rehabilitation.
  
  
  METHODS
  Ten years ago, the German DRG system tried to incorporate procedures (e.g., "early rehabilitation in geriatric medicine") in the hospital reimbursement system. OPS 8-550.x, defined by structural quality, days of treatment, and number of therapeutic interventions, triggers 17 different geriatric DRGs, covering most of the fields of medicine. OPS 8-550.x had been revised continuously to give a clear structure to quality aspects of geriatric procedures. However, OPS 8-550.x is based on proven need of in-hospital treatment. In the last 10 years, no such definition has been produced taking aspects of the German hospital system into account as well as aspects of transparency and benefit in everyday work.
  
  
  RESULTS
  The German DRG system covers just basic reimbursement aspects of geriatric medicine quite well; however, a practicable and patient-oriented definition of "hospital necessity" is still lacking, but is absolutely essential for proper compensation. A further problem concerning geriatric medicine reimbursement in the DRG system is due to the different structures of providing geriatric in-hospital care throughout Germany.
authors.affiliation: Fachbereich Geriatrie und Rehabilitation, Medizinische Klinik St. Bonifatius Hospital, Lingen, Deutschland.
authors.forename: G
authors.initials: G
authors.lastname: Kolb
authors.forename: K
authors.initials: K
authors.lastname: Breuninger
authors.forename: S
authors.initials: S
authors.lastname: Gronemeyer
authors.forename: D
authors.initials: D
authors.lastname: van den Heuvel
authors.forename: N
authors.initials: N
authors.lastname: Lübke
authors.forename: D
authors.initials: D
authors.lastname: Lüttje
authors.forename: A
authors.initials: A
authors.lastname: Wittrich
authors.forename: J
authors.initials: J
authors.lastname: Wolff
mesh_terms: D003695:Delivery of Health Care / Q000191:economics* / Q000639:trends; D003953:Diagnosis-Related Groups / Q000191:economics* / Q000639:trends; D005858:Germany; D006299:Health Services for the Aged / Q000191:economics* / Q000639:trends; D007902:Length of Stay; D009313:National Health Programs / Q000191:economics* / Q000639:trends; D012046:Rehabilitation / Q000191:economics* / Q000639:trends