Abstracts by keywords: Inpatient care
Since 2003, hospital services have been reimbursed through the case-volume-dependent, flat-rate reimbursement system of the G-DRG (German Diagnosis Related Groups) (Section 17b (1) Sentence 1 KHG/Reimbursement Institute 2023). Diagnosis, severity of the illness, and the operations and procedures performed, along with other parameters if applicable, are entered into the patient classification system for grouping (Reimbursement Institute 2023). Although other countries, such as the United Kingdom, Finland, and the Netherlands, also use DRG systems, Germany has a strong performance and volume incentive compared to other countries1. Despite the additional refinancing of nursing care through the nursing budget introduced in 2020 (Reimbursement Institute 2023), there is no case-volume-independent refinancing of necessary provision (Federal Ministry of Health 2023).
04.12.2023
As part of the Bertelsmann Foundation's “Reorganization of Hospital Care” project, a target image was developed for the German hospital landscape in 2030, which is primarily based on higher quality requirements without resulting in poorer accessibility. The starting point of the Bertelsmann Foundation's “Reorganization of the Hospital Landscape” project is the assessment, shared by numerous healthcare experts, that the hospital sector in Germany is still characterized by overcapacity, a particularly large number of small hospitals, as well as insufficient concentration and specialization, which lead to deficits in the quality of treatment , an above-average frequency of acquisition of patients via the emergency room as well as the treatment of patients without the need for inpatient treatment (so-called “outpatient-sensitive conditions”), loss of efficiency and sometimes ruinous competition.
04.10.2019
With the reform of the statutory health insurance provider's remuneration of the GKV WSG in 2007, the legislature decided that the total remuneration of the statutory health insurance associations, after standardization of the price component, would be determined primarily by the change in the necessary treatment requirements. To determine the necessary amount of services, the number and risk structure of insured persons residing in the area of responsibility of an association of statutory health insurance physicians as well as the shift in services between inpatient and statutory health care should be taken into account. Their determination - relevant to remuneration - proved to be a complex undertaking given the conflicting interests and the lack of an internationally established methodology. Fundamental methodological questions are still discussed in the evaluation committee; Only when these have been resolved can the money follow the performance. This results in the health economic importance of this research area, which has so far been little developed. This article aims to stimulate further methodological discussion using a simple projection.