G-IQI : German Inpatient Quality Indicators. Version 5.0 – Band 2

The German Inpatient Quality Indicators (G-IQI) have been developed for measuring outcome and volume indicators for specified diseases and/or procedures based on administrative data. In Germany the administrative billing data of the hospitals (the so called DRG-data) are electronically exchanged with the insurance companies and also once a year delivered to the federal office of statistics via standardized data interfaces (specifications according to § 21 KHEntgG and § 301 SGB V). G-IQI provide medically meaningful information about important and/or frequent diseases and procedures, which are treated or performed, respectively, in German hospitals. Wherever possible and medically sensible, information concerning outcome is provided besides volume indicators. In many cases this is the in-hospital mortality for the specific disease or procedure. This volume presents the revised G-IQI version 5.0 together with the technical specifications based on the German coding systems for the data year 2016. As compared to the preceding version 4.2 various indicators have been modified or more precisely specified. Some more indicators have been added. However, the major innovation in this version is the introduction of grading indicators. For certain groups of disease (like diseases of the heart) these allow to assess hospital performance via three dimensions: Service range, Volume, and Outcome where available. The evaluation is based on a comparison of the indicators of a single hospital versus the national distribution of these indicators. Details of this method will be described in a subsequent publication. As measured against the federal German DRG database 2014 the G-IQI indicators cover 45.2% of all in-patient cases in Germany. This is more than for other disease specific indicator systems. The in-hospital mortality indicators cover 55.9% of all in-hospital deaths. Volume 2 of G-IQI Version 5.0 also contains the federal reference values for all G-IQI indicators. The German federal DRG database of the latest available year 2014, which contains all non-psychiatric German inpatient cases, has been evaluated using the G-IQI Version 5.0 definitions. Thus hospitals using the G-IQI system can refer to the corresponding German reference values for inpatient mortalities, average case numbers per hospital and other indicators. This enables hospitals to judge their position in relation to a ‘German average hospital’. All reference values are published in this volume. As G-IQI contains a lot of complex disease and procedure indicators which are not published elsewhere, this evaluation also supplements the official German health statistics. Indicator systems like G-IQI can be used for public reporting. In this way G-IQI is used by the ‘Initiative Qualitätsmedizin’, an association of currently 377 German and Swiss hospitals publishing their results based on these indicators. Furthermore the Swiss Bundesamt für Gesundheit uses a Swiss variant of these indicators (CH-IQI) for an obligatory public reporting for all Swiss hospitals. Predominantly, however, G-IQI indicators are used within the internal quality management of the hospitals for further improving their outcome. Results which deviate from the federal average may and should be a reason for investigating the treatment processes of the respective disease, which may for example involve peer reviews of medical records. Using the indicators as a trigger tool it is possible to install an efficient and highly effective outcome oriented quality management within a hospital. The methods used for this purpose have been described in other publications.