Beatmungsfälle und Beatmungsdauer in deutschen Krankenhäusern

Eine Analyse von DRG-Anreizen und Entwicklungen in der Beatmungsmedizin

Size: 75 pages
Format: 21,0 x 29,7 cm
Publishing year: 2014
ISBN 978-3-7983-2630-9
12,50 

Since 2003/04 DRG-based hospital payments are used to reimburse hospitals activities in Germany. Like any other payment methodology, also DRG-based payments offer specific incentives for hospitals. The mechanical ventilation of patients and its duration is often discussed as a procedure examined in order to increase the revenues of hospitals. *Objective: The aim of this study was to examine the incentives created by a DRG-based payment system with regard to artificial respiration and to identify factors that could explain the considerable increase of mechanically ventilated patients. *Methods: Data provided by the Federal Statistical Office and the InEK were analyzed with regard to the development of the number of patients mechanically ventilated, the total number of ventilation hours, the age distribution and the DRGs for mechanical ventilation, using methods of descriptive and inferential statistics. Furthermore, the definitions of the DRGs for ventilation and changes in respiratory medicine were compared over the years. *Results: Since the introduction of the DRGs, the hours of ventilations and the number of patients mechanically ventilated have increased while mortality has decreased. During the same period there has been a switch to less invasive ventilation methods. The age distribution has shifted to higher age-groups. *Discussion: Due to advances in respiratory medicine, patients requiring ventilation can be treated by using a less complication-prone ventilation mode which simultaneously improves survival rates. There was no evidence supporting the assumption that the duration of mechanical ventilation is influenced by the intervals relevant for grouping. However, presumably operational arrangements of the hospital have a significant impact on the termination of mechanical ventilation. *Recommendations: Further studies investigating the distribution of the duration of mechanical ventilation within the respective DRG-groups should be conducted.