Peter J H
Schlafmedizinischen Labor, Philipps-Universität, Marburg, Deutschland.
Wien Med Wochenschr. 1996;146(13-14):395-401.
According to its rules it is the task of the German Sleep Research Society (DGSM) to promote scientific research in the area of Sleep Medicine in Germany and to transform scientific results into clinical practice for the benefit of patient care. The international classification of sleep disorders (ICSD) distinguishes more than 80 different disorders which can be treated due to scientific progress which has been made over the last 50 years. The conversion of established scientific knowledge in the field of sleep medicine into an improved clinical management of patients should not be prevented by the lack of sufficiently equipped sleep units. The federal government has stated that, due to financial constraints, it would not consent to any measures which might lead to a budget increase, such as case oriented special payments for certain diseases. Thus, an adequate number of sleep units can only be provided by integrating these units into the budget of the respective hospitals and departments, paid by the local insurance companies, thus providing the necessary financial resources to the sleep units. Many services in the area of sleep medicine can be covered by the existing reimbursement system. In some cases, however, a definite diagnosis can only be made by the use of complete polysomnography (PSG). For a complete PSG the additional costs have been calculated by the DGSM to be 1195,-DM per 24 h. Sleep units dealing with both diagnostically and therapeutically complex cases such as patients requiring complex forms of nasal ventilation, depend on an increase in the reimbursement by the insurance companies to cover the expenses involved. For each sleep unit, a "case-mix" can be calculated which will include both complex and less complex cases. The costs using this case mix will be considerably lower than the cost for a complete PSG. Sleep units provide the basis for education and quality assessment which are necessary for competent patient management in the future. Adequate diagnostic and therapeutic facilities in sleep medicine provide the basis for patient care, contribute to improved health standards and, thus, reduce social costs of these frequent diseases.
根据其章程，德国睡眠研究协会（DGSM）的任务是促进德国睡眠医学领域的科学研究，并将科研成果转化为临床实践，以造福患者护理。国际睡眠障碍分类（ICSD）区分了80多种不同的睡眠障碍，由于过去50年所取得的科学进展，这些睡眠障碍都可以得到治疗。睡眠医学领域已确立的科学知识向改善患者临床管理的转化，不应因缺乏设备充足的睡眠单元而受阻。联邦政府表示，由于财政限制，它不会同意采取任何可能导致预算增加的措施，例如针对某些疾病的按病例定向特别支付。因此，只有将这些睡眠单元纳入各医院和科室的预算，由当地保险公司支付费用，才能提供足够数量的睡眠单元，从而为睡眠单元提供必要的财政资源。睡眠医学领域的许多服务可由现有的报销系统覆盖。然而，在某些情况下，只有通过使用完整的多导睡眠图（PSG）才能做出明确诊断。DGSM计算得出，进行一次完整的PSG，每24小时的额外费用为1195德国马克。处理诊断和治疗复杂病例（如需要复杂鼻通气形式的患者）的睡眠单元，依赖于保险公司提高报销额度以支付相关费用。对于每个睡眠单元，可以计算出一个“病例组合”，其中将包括复杂病例和不太复杂的病例。使用这种病例组合的成本将大大低于完整PSG的成本。睡眠单元为未来胜任患者管理所需的教育和质量评估提供了基础。睡眠医学中充足的诊断和治疗设施为患者护理提供了基础，有助于提高健康水平，从而降低这些常见疾病的社会成本。
