[In-patient (early) rehabilitation]

Area of Science:

• Healthcare financing
• Rehabilitation medicine
• Health economics

Background:

• The diagnosis-related group (DRG) system presents challenges for financing and hospital provision of early rehabilitation interventions.
• Three main forms of early rehabilitative interventions are recognized: geriatric, neurological/neurosurgical, and interdisciplinary.
• Current DRG system coverage varies, with geriatric and neurological rehabilitation integrated, while interdisciplinary rehabilitation is less represented.

Purpose of the Study:

• To analyze and compare the definitions and cost-effectiveness of different early rehabilitative interventions within the DRG system.
• To evaluate the integration and representation of geriatric, neurological, and interdisciplinary early rehabilitation in current healthcare financing models.
• To determine the necessary financial adjustments for comprehensive early rehabilitation provision.

Main Methods:

• Comparative analysis of definitions and cost-effectiveness of early rehabilitation interventions.
• Examination of the DRG system's current structure and its reflection of different rehabilitation types.
• Assessment of the need for additional financial provisions for underrepresented rehabilitation services.

Main Results:

• Early rehabilitative interventions require constant therapeutic team cooperation, notably neurological rehabilitation involving nursing as a therapeutic profession.
• Geriatric early rehabilitation is common in general hospitals, and neurological early rehabilitation is found in specialized institutions, both reflected in the DRG system.
• Interdisciplinary early rehabilitation is underrepresented in the DRG system, indicating a gap in coverage and financing.

Conclusions:

• The current DRG system adequately reflects geriatric and neurological early rehabilitation but inadequately covers interdisciplinary early rehabilitation.
• To ensure all acute inpatients needing early rehabilitation receive it, an additional fee for interdisciplinary services is essential.
• Implementing supplementary financing for interdisciplinary early rehabilitation is crucial for equitable access to comprehensive care.