Nimptsch Ulrike, Schmithausen Daniel, Winklmair Claudia, Busse Reinhard, Augurzky Boris, Kuhlen Ralf
Technische Universität Berlin, Fachgebiet Management im Gesundheitswesen.
Solventum Germany GmbH.
Dtsch Med Wochenschr. 2025 Apr;150(9):e18-e27. doi: 10.1055/a-2530-3973. Epub 2025 Mar 19.
In Germany, the Hospital Care Improvement Act (Krankenhausversorgungsverbesserungsgesetz) will introduce service groups for hospital reserve financing. The hospital planning of the federal states is also intended to allocate care contracts to hospitals based on service groups in conjunction with structural quality criteria. This paper analyzes service group-specific differences in treatment case characteristics as well as differences in process and outcome quality indicators.The study used the frequent treatment causes of pneumonia, cerebral infarction and colorectal resection for carcinoma as examples. Administrative data for the year 2023 from 422 hospitals were analyzed. Treatment cases were assigned to NRW hospital service groups and, in a cross comparison, to figures of the German Inpatient Quality Indicators (G-IQI).For the treatment causes of pneumonia (N=129666), cerebral infarction (N=95762) and colorectal resection for carcinoma (N=16578), more than 60% of cases were assigned to one dominant service group, while the remaining cases were distributed across different service groups. Care characteristics differed according to the service group assignment. For example, intracranial thrombectomy was documented in 10.3% of cases with cerebral infarction overall (9856 of 95762 cases). In the "Stroke Unit" service group, this proportion was 11.3% (6790 of 60246 cases), in the "General Neurology" service group it was 5.7% (836 of 14692 cases).The assignment of cases to service groups primarily reflects the type of care. To promote the intended control effect with the aim of increasing the hospital's specialization, the classification of service groups might be more strongly oriented towards the clinical care requirements of relevant treatment causes.
在德国,《医院护理改善法案》(Krankenhausversorgungsverbesserungsgesetz)将引入用于医院储备资金的服务组。联邦州的医院规划还打算根据服务组并结合结构质量标准将护理合同分配给医院。本文分析了特定服务组在治疗病例特征方面的差异以及过程和结果质量指标方面的差异。该研究以肺炎、脑梗死和结肠癌大肠切除术等常见治疗病因为例。分析了2023年来自422家医院的行政数据。将治疗病例分配到北莱茵 - 威斯特法伦州(NRW)医院服务组,并通过交叉比较,与德国住院患者质量指标(G - IQI)的数据进行对比。对于肺炎(N = 129666)、脑梗死(N = 95762)和结肠癌大肠切除术(N = 16578)的治疗病因,超过60%的病例被分配到一个主要服务组,而其余病例则分布在不同服务组。护理特征因服务组分配而异。例如,总体上10.3%的脑梗死病例(95762例中的9856例)记录了颅内血栓切除术。在“卒中单元”服务组中,这一比例为11.3%(60246例中的6790例),在“普通神经科”服务组中为5.7%(14692例中的836例)。病例分配到服务组主要反映了护理类型。为了以提高医院专业化为目标促进预期的控制效果,服务组的分类可能更强烈地以相关治疗病因的临床护理要求为导向。