Fiori W, Roeder N, Lakomek H-J, Liman W, Köneke N, Hülsemann J L, Lehmann H, Wenke A
Universitätsklinikum Münster, DRG-Research-Group, Domagkstr. 20, 48129 Münster, Germany.
Z Rheumatol. 2005 Feb;64(1):58-69. doi: 10.1007/s00393-005-0702-z.
The German prospective payment system G-DRG has been recently adapted and recalculated. Apart from the adjustments of the G-DRG classification system itself changes in the legal framework like the extension of the "convergence period" or the limitation of budget loss due to DRG introduction have to be considered. Especially the introduction of new procedure codes (OPS) describing the specialized and complex rheumatologic treatment of inpatients might be of significant importance. Even though these procedures will not yet develop influence on the grouping process in 2005, it will enable a more accurate description of the efforts of acute-rheumatologic treatment which can be used for further adaptations of the DRG algorithm. Numerous newly introduced additive payment components (ZE) result in a more adequate description of the "DRG-products". Although not increasing the individual hospital budget, these additive payments contribute to more transparency of high cost services and can be addressed separately from the DRG-budget. Furthermore a lot of other relevant changes to the G-DRG catalogue, the classification systems ICD-10-GM and OPS-301 and the German Coding Standards (DKR) are presented.
德国前瞻性支付系统G-DRG最近进行了调整和重新计算。除了G-DRG分类系统本身的调整外,还必须考虑法律框架的变化,如“趋同期”的延长或因引入DRG导致的预算损失限制。特别是引入描述住院患者专科和复杂风湿病治疗的新程序代码(OPS)可能具有重要意义。尽管这些程序在2005年尚未对分组过程产生影响,但它将使对急性风湿病治疗工作的描述更加准确,可用于DRG算法的进一步调整。众多新引入的附加支付组件(ZE)使对“DRG产品”的描述更加充分。这些附加支付虽然不会增加单个医院的预算,但有助于提高高成本服务的透明度,并且可以与DRG预算分开处理。此外,还介绍了G-DRG目录、ICD-10-GM和OPS-301分类系统以及德国编码标准(DKR)的许多其他相关变化。