Zeitschrift für Kardiologie
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Cardiovascular diseases are systemic processes frequently involving multiple vascular beds. Cardiovascular multimorbidity, arbitrarily defined as a clinically relevant disease of at least two major vascular beds in a single individual is frequent occurring in 30% to 70% of patients depending on the patient population. Management of patients with cardiovascular multimorbidity is complex requiring an interdisciplinary consensus and coordination. A panvascular concept of an interdisciplinary integrated management of these patients is introduced.
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Based on the medical and economical data of 137 German hospitals including 12 university hospitals, the Institut für das Entgeltsystem im Krankenhaus (InEK) was again authorized by the German Ministry of Health to calculate and develop a refined version of the German diagnosis related groups (G-DRG) for the year 2004. The catalogue of these updated GDRGs was published on October 15' 2003. Furthermore, the grouper programs containing the current algorithms and the cost data on which the new G-DRGs were based have been published in the last few weeks. ⋯ In conclusion, a number of improvements have been implemented in the updated G-DRG system which had in part been suggested by several national medical societies. These provide the basis for more precise and detailed DRGs but require on the other hand, a precise and complete coding to allow correct grouping procedures. From an economical point of view, it could hardly be summarized whether these improvements would lead to an adequate reimbursement for the treatment costs of patients with cardiovascular diseases since the case-mix of the various departments may vary widely.