[The effects of DRG introduction on nursing]

Nursing personnel associate Diagnosis Related Groups (DRG), implemented in German hospitals in 2004, mostly with a higher workload and with work that is set apart from their patients. Between 2003 and 2005 the Institut für Pflegewissenschaft, Universität Witten/Herdecke, conducted a longitudinal study to measure changes of working structures before, throughout and after the introduction of the case-based lump sum. At three given dates a structured questionnaire was applied to nursing staff and, partially, to doctors in three hospitals in order to assess their subjective view on the effects of DRG introduction. RESULTS were compared to the actual output by multi-moment-recording.

The amount of paperwork decreased against expectations. Nevertheless, extra requirements became more comprehensive, while the extent of genuine nursing tasks decreased. In 2005 these tasks were given a lower amount of time than paperwork and extra requirements. Because of methodical restrictions causal relations cannot be established, but this trend has to be monitored closely. Further studies have to be carried out to examine structural changes of nursing tasks and quality of care.