Background and objectives An important component of efficient and high-quality treatment of patients under DRG conditions is the control of patients' length of stay in hospitals. Medical processes need to be structured in such a way that unnecessary extensions of the length of stay are avoided, thus achieving an economically and qualitatively optimal result. The study presented here examines the question of whether the introduction of length-of-stayoriented case management can optimize the duration of patients' hospital stays. Methods In total, 168 inpatient cases and their matched control cases from the cardiology and urology stations of a maximum care hospital are examined in this study. Results The result of the t-test for the difference of means indicates that the average length of stay of the intervention cases (5.79 days) was significantly shorter than the average length of stay of the control cases (7.34 days). With respect to the re-admission rate, a statistically significant dependence could not be determined.
So far, none of the approaches investigated provides a comprehensive and empirically tested explanation of the changes in the German hospital market. However, some of the approaches provide a theoretical background for part of the changes. As this dynamic market is economically of high significance, there is a need for further development and empirical testing of relevant theoretical approaches.
Staffing level: Survey among psychosomatic-psychotherapeutic institutions in GermanyObjectives: To establish the first nationwide hospital survey to assess the level of staffing for inpatient and daycare treatment in psychosomatic hospitals and specialist departments in Germany. Methods: Using a standardized written hospital survey from the Deutsches Krankenhausinstitut (DKI), we invited a total of 218 psychosomatic-psychotherapeutic hospitals and specialist departments to participate. The participation rate of the institutions was 35 %. Results: In the overall sample, one psychotherapist (physician/clinical psychologist) was responsible for treating a median of 3.9 beds/patients (interquartile range 3.1-5.1) and one nurse a median of 2.9 beds/patients (interquartile range 2.3-3.9). There were significant differences for the nurse-patient ratio depending on the organizational size of the institution. To ensure quality treatment, professional experts saw increased staffing needs of about 12-17 % across both professions. For the professional groups of specialist therapists and social workers, broad variances were observed for the therapist-patient ratio in the overall sample.
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