Auswirkungen des DRG-Systems auf Anschluss- und Rehabilitationsbehandlung in Sydney,
New South Wales, Australien

 

 Buy Article Permissions and Reprints

Zusammenfassung

Die bevorstehende Einführung des DRG-Systems in Deutschland bringt Ungewissheit für die Behörden, die Ärzte, das Pflegepersonal und für alle weiteren Personen, die mit dem Gesundheitswesen zu tun haben, die Patienten eingeschlossen. Wie zuvor schon in anderen Ländern, wird sich auch in Deutschland aufgrund dieser Neuerung vieles verändern. Aber eine gezielte, effiziente und qualitätsgesicherte medizinische Betreuung soll und kann auch weiter gefördert werden. Der vorliegende Kurzbericht fasst die Auswirkungen auf die Schnittstelle zwischen der Akutversorgung und der nachgeordneten Rehabilitation durch die Einführung des DRG-Systems in Sydney, New South Wales, Australien zusammen und geht anschließend noch auf die weitere Entwicklung ein.

Abstract

The forthcoming introduction of a DRG system in Germany has entailed numerous uncertainties for the agencies involved, for medical and care staff as well as all others having to do with the health care system, the patients included. As had previously been the case in other countries, this innovation is going to effect major changes in Germany as well. Notwithstanding, efforts to enhance specific, efficient and quality-assured medical care can, and are intended to, be undertaken in the future as well. This short report summarizes the impact introduction of a DRG system has had at the interface between acute care and subsequent rehabilitation in Syndey, New South Wales; concluding, future developments are outlined.

Literatur

• 1 Australian Casemix Clinical Committee .Report to the Commonwealth Department of Health, Housing and Community Services on the development of the Australian inpatient casemix classification. Canberra; Casemix Branch, the Department 1992: 1-145
• 2 3M Health Information Systems .Australian national diagnosis related groups. Definitions manual. Version 1.0. Sydney; 3M Health Information Systems 1992: 1-1034
• 3 Fetter R B, Shin Y, Freeman J I, Averill R F, Thompson J D. Case mix definition by diagnosis related groups.  Med Care. 1980;  18 (Suppl. 2) 1-53
  PubMedGoogle Scholar
• 4 Bamard C, Esmond T. DRG-based reimbursement: The use of concurrent and retrospective clinical data.  Med Care. 1981;  19 (11) 1071-1082
  PubMedGoogle Scholar
• 5 Eagar K, et al. The Australian national sub-acute and non-acute patient classification (AN-SNAP): report of the national sub-acute and non-acute casemix classification study. Wollongong; Centre for Health Service Development, University of Wollongong 1997
• 6 Information and publications unit, information and data services branch .NSW Health. NSW Public Hospitals Comparison Data Book 1993 4: 4-5
  Google Scholar
• 7 Information and publications unit, information and data services branch .NSW Health. NSW Public Hospitals Comparison Data Book 1998 9: 4-5
  Google Scholar
• 8 Sloan F A, Morrisey M A, Valvona J. Case shifting and the Medicare prospective payment system.  Am J Public Health. 1988;  78 553-556
  PubMedGoogle Scholar
• 9 Evans R L, Hendricks R D, Bishop D S, Lawrence-Umlauf K V, Kirk C, Halar E M. Prospective payment for rehabilitation: Effects on hospital readmission, home care, and placement.  Arch Phys Med Rehabil. 1990;  71 291-294
  PubMedGoogle Scholar
• 10 Morrisey M A, Sloan F A, Valvona J. Medicare prospective payment and posthospital transfers to subacute care.  Med Care. 1988;  26 685-694
  PubMedGoogle Scholar
• 11 Kahn K L, Keeler E B, Sherwood M J, Rogers W H, Draper D, Bentow S S, Reinisch E J, Rubenstein L F. Comparing outcomes of care before and after implementation of the DRG-based prospective payment system.  JAMA. 1990;  264 (15) 1984-1988
  CrossrefPubMedGoogle Scholar
• 12 Wood J B, Estes C L. The impact of DRGs on community based service providers: Implications for the elderly.  Am J Public Health. 1990;  80 840-843
  PubMedGoogle Scholar
• 13 Rogers W H, Draper D, Kahn K L, Keeler E B, Rubenstein L V, Kosecoff J, Brook R H. Quality of care before and after implementation of the DRG-based prospective payment system.  J Am Med Ass. 1990;  264 1989-1994
  CrossrefPubMedGoogle Scholar
• 14 Gay E G, Kronenfeld J J. Regulation, retrenchment - the DRG experience: problems from changing reimbursement practice.  Social Science and Medicine. 1990;  31 (10) 1103-1118
  PubMedGoogle Scholar
• 15 Duckett S J. Casemix funding in Victoria: The first year.  The Med J of Australia. 1995;  162 650-654
  PubMedGoogle Scholar
• 16 Stinemann M G, Escarce J J, Goin J E, Hamilton B B, Granger C V, Williams S V. A casemix classification system for medical rehabilitation.  Med Care. 1994;  32 366-379
  PubMedGoogle Scholar
• 17 Stinemann M G, Tassoni C J, Escarce J J, Goin J E, Granger C V, Fiedler R C, Williams S V. Development of function-related groups version 2.0: a classification system for medical rehabilitation.  Health Services Research. 1997;  32 (4) 529-548
  PubMedGoogle Scholar
• 18 Fries B E, Cooney L M. Resource utilisation groups: A patient classification system for long-term care.  Med Care. 1985;  23 110-122
  PubMedGoogle Scholar
• 19 Cooner L M , Fries B E. Validation and use of resource utilisation groups as a case-mix measure for long-term care.  Med Care. 1985;  23 123-132
  PubMedGoogle Scholar
• 20 Lee L, Goor E, Kennedy C, Walters S, Kirby L. Non acute casemix in the Illawarra.  J Qual Clin Pract. 1994;  14 23-30
  PubMedGoogle Scholar
• 21 Deane R T, Cella M A. New concepts in nursing home reimbursement. Working paper. Silver Spring, Md; Applied Management Sciences 1981
• 22 Keith R A, Granger C V, Hamilton B B, Sherwin F S. The Functional Independence Measure: A new tool for rehabilitation. In: Eisenberg MG, Grzesiak RC (Hrsg) Advances in Clinical Rehabilitation, Vol. 2. New York, NY; Springer 1987: 6-18
  Google Scholar
• 23 Mahoney F I, Barthel D W. Functional evaluation: the Barthel Index.  Md State Med. 1965;  14 (2) 61-65
  PubMedGoogle Scholar
• 24 Wing J, Curtis R, Beevor A. HoNOS: The Health of the Nation Outcomes Scales, report on research July 1993 - December 1995. London; College Research Unit, Royal College of Psychiatrists 1996

Dr. Friedbert Köhler

Rehabilitation Liverpool and Braeside Hospitals

Locked Bag 82
Wetherill Park, NSW, 2164, Sydney, Australien

Email: F.Kohler@unsw.edu.au