Frick U, Barta W, Binder H
AG Versorgungsforschung, Klinik und Poliklinik für Psychiatrie der Universität Regensburg.
Psychiatr Prax. 2001 Jul;28 Suppl 1:S55-62. doi: 10.1055/s-2001-15388.
Hospital financing via case-related prospective payment sometimes is suspected to be responsible for accelerating the "revolving-door"-phenomenon in psychiatry. According to this reasoning, establishing diagnoses-related groups (DRGs) ruling a prospective payment system could not only reduce lengths of stay but could also simultaneously raise hospitalization and readmission rates. This study analyses the Austrian experience after the implementation of such a payment system, the "performance-oriented financing of hospitals" (leistungsorientierte Krankenanstalten-Finanzierung, LKF) in 1997. Time series analyses based on the complete hospital discharge statistics of the Salzburg province were used as methods. Results showed that neither length of stay, nor hospitalization or readmission rates in psychiatry have substansially changed or deviated from their long-term trends after implementation of the LKF system. Other medical disciplines have experienced statistically significant changes. The possibility to transfer these results to the German psychiatric health care system is discussed.
通过按病例相关的前瞻性支付进行医院融资有时被怀疑是导致精神病学中“旋转门”现象加速的原因。根据这种推理，建立用于前瞻性支付系统的诊断相关组（DRGs）不仅可以缩短住院时间，还可能同时提高住院率和再入院率。本研究分析了1997年实施这种支付系统，即“医院绩效导向融资”（leistungsorientierte Krankenanstalten-Finanzierung，LKF）后奥地利的经验。采用基于萨尔茨堡省完整医院出院统计数据的时间序列分析方法。结果表明，在实施LKF系统后，精神病学领域的住院时间、住院率或再入院率均未发生实质性变化，也未偏离其长期趋势。其他医学学科则经历了具有统计学意义的变化。文中讨论了将这些结果应用于德国精神卫生保健系统的可能性。
