[Hospital service groups and quality indicators - A cross-comparison for pneumonia, ischemic stroke, and colorectal...

In Germany, the Hospital Care Improvement Act (Krankenhausversorgungsverbesserungsgesetz) will introduce service groups for hospital reserve financing. The hospital planning of the federal states is also intended to allocate care contracts to hospitals based on service groups in conjunction with structural quality criteria. This paper analyzes service group-specific differences in treatment case characteristics as well as differences in process and outcome quality indicators.The study used the frequent treatment causes of pneumonia, cerebral infarction and colorectal resection for carcinoma as examples. Administrative data for the year 2023 from 422 hospitals were analyzed. Treatment cases were assigned to NRW hospital service groups and, in a cross comparison, to figures of the German Inpatient Quality Indicators (G-IQI).For the treatment causes of pneumonia (N=129666), cerebral infarction (N=95762) and colorectal resection for carcinoma (N=16578), more than 60% of cases were assigned to one dominant service group, while the remaining cases were distributed across different service groups. Care characteristics differed according to the service group assignment. For example, intracranial thrombectomy was documented in 10.3% of cases with cerebral infarction overall (9856 of 95762 cases). In the "Stroke Unit" service group, this proportion was 11.3% (6790 of 60246 cases), in the "General Neurology" service group it was 5.7% (836 of 14692 cases).The assignment of cases to service groups primarily reflects the type of care. To promote the intended control effect with the aim of increasing the hospital's specialization, the classification of service groups might be more strongly oriented towards the clinical care requirements of relevant treatment causes.