科研之友
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摘要
In 2003 the German health financing system for inpatients was converted from a time-related system to a system of diagnosis-related groups. This constituted a fundamental change in hospital finance management. Since 2004, the catalogue of diagnosis-related groups has been revised on an annual basis. The underlying calculations are based on data sets from all participating hospitals. However, these calculations do not directly base on evidence-based medical data. The current financial situation for hospitals in Germany is greatly influenced by external factors such as rises in value-added tax, wage agreements, and increased energy costs. Cost unit calculations are rarely compiled in German clinics, and most benchmark analyses are based on estimated cost data. As an illuminating example for allergology-related afflictions we present the cost analysis for immunotherapy using hymenoptera, venom, drug provocation tests and chronic urticaria. This is compared to dermatological cases such as atopic eczema and erysipela. The daily cost of coverage was calculated. For the cases presented, a comparison of these costs over recent years shows a substantial decline. This development is not only a phenomenon in clinical treatment of allergological diseases but is also seen in dermatological inpatient treatment. Thus, a course for consequent optimization and rationalization is required. Therefore, a critical appraisal of economic factors, together with medical expertise in daily clinical routine, has to be considered. Furthermore, the health financing system must be consistently oriented around evidence-based medical criteria. These are conditions that must be met in order for funding and costs of good clinical practice to break even.
- 出版日期2007-10
- 单位河南工业大学
