[Quality of hospital care in Germany: analysis of the trend between 2004 and 2008 from external quality assurance data].
OBJECTIVE
Introducing fixed fees for inpatient hospital care has raised fears of a negative influence on treatment quality. To address these concerns, an external quality assurance was implemented. The results of the quality indicators should indicate changes in the quality of inpatient care between 2004 and 2008.


METHODS
On the basis of the evaluation data delivered by the Federal Quality Assurance Agency, quality indicators with similar results of at least 3 subsequent years were included. A trend was identified with linear regression as well as with a constant change in the results. 204 quality indicators of 19 health care sectors of 6 diagnosis groups were included.


RESULTS
Half of the quality indicators showed a particularly striking quality improvement in the categories "indication" and "process". The lowest number of quality indicators with a quality improvement occurred in the cardiac surgery. To this diagnosis group also belong 13 of the 18 quality indicators with deterioration. Sixteen of the 18 quality indicators rank among the category "result".


CONCLUSIONS
The quality of inpatient care improved substantially from 2004 through 2008, measured against the quality indicators of the external comparable quality assurance. This corresponds to other analyses of a similar time period in Germany of the same or different data sources. Those analyses showed additionally that the subjective perceptions of clinicians and of nursing staff are significantly worse.
Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität München.
J
J
Stausberg
Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität München.
K
K
Berghof
D019985:Benchmarking / Q000458:organization & administration / Q000592:standards; D003695:Delivery of Health Care / Q000592:standards* / Q000639:trends*; D003953:Diagnosis-Related Groups / Q000592:standards; D005544:Forecasting; D005858:Germany; D006302:Health Services Research / Q000458:organization & administration / Q000639:trends; D006761:Hospitals / Q000592:standards* / Q000639:trends*; D006801:Humans; D009313:National Health Programs / Q000592:standards* / Q000639:trends*; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration / Q000639:trends; D011785:Quality Assurance, Health Care / Q000592:standards* / Q000639:trends*; D058996:Quality Improvement / Q000458:organization & administration / Q000639:trends; D019984:Quality Indicators, Health Care / Q000592:standards / Q000639:trends