[Impact of hospital diagnostic related groups on geriatric rehabilitation facilities]

The introduction of the DRGs (diagnosis related groups) for paying hospitals in Germany in 2003 will result in changes in quality, quantity and financial flows foremost for the hospital sector but also for the important sector of the geriatric rehabilitation. This geriatric sector will experience a growth in total patient numbers, an enhanced and altered service range and a change in the market relationship towards the hospitals. The introduction of case-related payments also for the geriatric rehabilitation could, on the one hand, reduce the negative spillover effects from the hospital sector and, on the other hand, guaranty an efficient service provision. Furthermore, there would be a good comparability among the geriatric rehabilitation facilities and between costs in institutions of geriatric rehabilitation and hospitals. If hospital and geriatric rehabilitation services were payed by case-related payments, efficiency of health care services could be further improved by a broad definition of cases (complex case-based reimbursement), including care in the hospital as well as the care in the rehabilitation clinic afterwards. If rehabilitation would be financed by case-based reimbursement as well as by of a complex case-based reimbursement, a quality assurance program would be necessary.