DRG-induzierte Veränderungen und ihre Auswirkungen
7. Die mittleren und großen Krankenhäuser sind auch unter DRG-Bedingungen überwiegend ökonomisch erfolgreich, weil sie die Möglichkeiten zur strategischen Neuausrichtung nutzen können, während dies für die kleineren Krankenhäuser deutlich schwieriger ist.
DRG-induced effects on healthcare
The objective of the study was the analysis of the effects attributable to diagnosis related groups (DRG) on the maintenance and performance of care in hospitals. Based on a representative sample of 30 hospitals in Lower Saxony and a differentiated methodological approach, the following could be shown:
1. The immediate quality of care in hospitals has not changed in general due to the DRG-system.
2. There is no evidence for a selection of profitable patient cases.
3. The phenomenon of a so-called “bloody” discharge cannot be proved.
4. An increase of unexpected re-admission after discharge due to the DRGsystem is not provable.
5. Hospitals have prepared for the operative implementation of the DRGsystem, but only a few have a forward-looking strategic orientation and complete reorganization of the essential care processes in focus.
6. Working conditions for professionals have changed parallel to the DRGsystem, but the expenditure for DRG-coding and documentation is generally over-estimated.
7. Medium-sized and large hospital organizations are economically successful even under DRG-conditions, because they can make use of strategic orientation, while economic success is harder to achieve for small hospitals.
Diagnosis related groups (DRG), Versorgungsforschung, Qualität, Krankenhaus, Diagnosis related groups (DRG), Quality of care, Hospitals
Dr. phil. Brigitte Sens, Paul Wenzlaff, Dr. med. Gerd Pommer, Prof. Dr. med. Horst von der Hardt