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[Diagnosis related groups in stroke treatment. An analysis from the stroke data bank of the German Stroke Foundation]
C Weimar1, J Stausberg, K Kraywinkel
1Neurologische Klinik, Universität Essen. stroke.med@uni-essen.de
Insights
The Australian Refined Diagnosis Related Groups (AR-DRG) system may decrease hospital proceeds in German neurology departments and for transient ischemic attack (TIA) treatment. Adjustments are needed to maintain acute stroke care quality.
Area of Science:
- Health Economics
- Neurology
- Hospital Management
Context:
- Germany is introducing Diagnosis Related Groups (DRG) for hospital reimbursement.
- Accurate cost data analysis is crucial for the transition.
- Stroke treatment costs require specific evaluation.
Purpose:
- To compare Australian Refined Diagnosis Related Groups (AR-DRG) cost weights with actual per-day rates for stroke treatment in Germany.
- To assess the financial impact of AR-DRG implementation on neurology departments and TIA cases.
Summary:
- A prospective study analyzed data from 6520 stroke and TIA patients across various German departments.
- Cost weights were calculated using ICD-10-SGB-V 2.0 and MBS-Extended, compared against per-day rates.
- Results indicate good homogeneity of cost weights relative to length of stay.
Impact:
- Implementing AR-DRG with a uniform base rate may reduce hospital proceeds in neurology and for TIA treatment.
- Maintaining the current acute stroke care structure necessitates supplementary measures beyond a uniform base rate for neurology departments.
Background:
The upcoming introduction of diagnosis related groups (DRG) as an exclusive base for future calculation of hospital proceeds in Germany requires a thorough analysis of cost data for various diseases.
Objective:
To compare the resulting combined cost weights of the Australian Refined DRG system (AR-DRG) with the proceeds based on actual per-day rates in stroke treatment.
Patients And Methods:
Between 1998 and 1999, data from 6520 patients (median age 68 years, 43% women) with acute stroke or transient ischemic attack (TIA) were prospectively documented in 15 departments of Neurology with an acute stroke unit, 9 departments of general Neurology and 6 departments of Internal Medicine. Prior to grouping cases into DRGs, all available data were transferred into ICD-10-SGB-V 2.0 or the Australian procedure system (MBS-Extended). Hospital proceeds for the respective cases were calculated based on per-day rates of the documenting hospitals.
Results:
The resulting cost weights demonstrate a good homogeneity compared to the length of stay. When introducing the AR-DRG with a uniform base rate in Germany, a relative decrease of hospital proceeds can be expected in Neurology Departments and for treatment of TIAs.
Conclusion:
Preservation of the existing structure of acute stroke care in Germany requires a supplement to a uniform base rate in Neurology departments.
