| Title |
Redefining diagnosis-related groups (DRGs) for palliative care – a cross-sectional study in two German centres
|
|---|---|
| Published in |
BMC Palliative Care, April 2018
|
| DOI | 10.1186/s12904-018-0307-3 |
| Pubmed ID | |
| Authors |
Matthias Vogl, Eva Schildmann, Reiner Leidl, Farina Hodiamont, Helen Kalies, Bernd Oliver Maier, Marcus Schlemmer, Susanne Roller, Claudia Bausewein |
| Abstract |
Hospital costs and cost drivers in palliative care are poorly analysed. It remains unknown whether current German Diagnosis-Related Groups, mainly relying on main diagnosis or procedure, reproduce costs adequately. The aim of this study was therefore to analyse costs and reimbursement for inpatient palliative care and to identify relevant cost drivers. Two-center, standardised micro-costing approach with patient-level cost calculations and analysis of the reimbursement situation for patients receiving palliative care at two German hospitals (7/2012-12/2013). Data were analysed for the total group receiving hospital care covering, but not exclusively, palliative care (group A) and the subgroup receiving palliative care only (group B). Patient and care characteristics predictive of inpatient costs of palliative care were derived by generalised linear models and investigated by classification and regression tree analysis. Between 7/2012 and 12/2013, 2151 patients received care in the two hospitals including, but not exclusively, on the PCUs (group A). In 2013, 784 patients received care on the two PCUs only (group B). Mean total costs per case were € 7392 (SD 7897) (group A) and € 5763 (SD 3664) (group B), mean total reimbursement per case € 5155 (SD 6347) (group A) and € 4278 (SD 2194) (group B). For group A/B on the ward, 58%/67% of the overall costs and 48%/53%, 65%/82% and 64%/72% of costs for nursing, physicians and infrastructure were reimbursed, respectively. Main diagnosis did not significantly influence costs. However, duration of palliative care and total length of stay were (related to the cost calculation method) identified as significant cost drivers. Related to the cost calculation method, total length of stay and duration of palliative care were identified as significant cost drivers. In contrast, main diagnosis did not reflect costs. In addition, results show that reimbursement within the German Diagnosis-Related Groups system does not reproduce the costs adequately, but causes a financing gap for inpatient palliative care. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 1 | 33% |
| Unknown | 2 | 67% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 67% |
| Scientists | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 44 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 44 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 7 | 16% |
| Researcher | 6 | 14% |
| Student > Postgraduate | 5 | 11% |
| Student > Bachelor | 3 | 7% |
| Student > Ph. D. Student | 3 | 7% |
| Other | 7 | 16% |
| Unknown | 13 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Nursing and Health Professions | 11 | 25% |
| Medicine and Dentistry | 8 | 18% |
| Business, Management and Accounting | 2 | 5% |
| Economics, Econometrics and Finance | 2 | 5% |
| Biochemistry, Genetics and Molecular Biology | 1 | 2% |
| Other | 4 | 9% |
| Unknown | 16 | 36% |
Attention Score in Context
This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 September 2018.
All research outputs
#3,716,337
of 23,041,514 outputs
Outputs from BMC Palliative Care
#467
of 1,257 outputs
Outputs of similar age
#74,272
of 329,678 outputs
Outputs of similar age from BMC Palliative Care
#31
of 47 outputs
Altmetric has tracked 23,041,514 research outputs across all sources so far. Compared to these this one has done well and is in the 83rd percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
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