Das Gesundheitswesen
-
Das Gesundheitswesen · Feb 2013
[The challenge of adequate reimbursement for the seriously injured patient in the German DRG system].
Critically injured patients are a very heterogeneous group, medically and economically. Their treatment is a major challenge for both the medical care and the appropriate financial reimbursement. Systematic underfunding can have a significant impact on the quality of patient care. In 2009 the German Trauma Society and the DRG-Research Group of the University Hospital Muenster initialised a DRG evaluation project to analyse the validity of case allocation of critically injured patients within the German DRG system versions 2008 and 2011 with additional consideration of clinical data from the trauma registry of the German Trauma Society. Severe deficits within the G-DRG structure were identified and specific solutions were designed and realised. ⋯ The quality of the G-DRG system is measured by the ability to obtain adequate case allocations for highly complex and heterogeneous cases. Specific modifications of the G-DRG structures could increase the appropriateness of case allocation of critically injured patients. Additional consideration of the ISS clinical data must be further evaluated. Data-based analysis is an essential prerequisite for a constructive development of the G-DRG system and a necessary tool for the active participation of medical societies in this process.
-
Studies on the health behaviour of adolescents mostly examine single health behaviour indicators in a separate manner for each one. However, health behaviours are not independently developed, but occur within a broader behavioural scheme acquired during socialisation. The aim of this study is to analyse the distribution of health-related behaviour patterns in adolescence by using a composite index made up of 6 single indicators allowing for sociodemographic and socioeconomic variables. ⋯ The results of the created HLI refer to latent potentials for prevention and specific target groups for health promotion measures.