DRG Benchmarking: Analysis of service structures and ‐differences in dermatology departments

Kis

et al. 2021

Self Cite

Summary Background In Germany, skin diseases are mainly treated in the 115 dermatological hospitals. Methods Health care and health economic analysis of dermatological inpatient care and prediction of future care needs based on primary and secondary data. Results Outpatient and inpatient care for dermatologic treatment indications is predominantly provided by dermatology specialists. Inpatient treatment was provided for 833,491 cases in 2018, corresponding to 4.21 % of all inpatient cases (19,808,687). Most common treatment cases were: epithelial skin cancer (total 87,386, of which dermatology clinics 52,608), followed by melanoma (23,917/17,774), psoriasis (19,291/13,352), erysipelas (73,337/11,260), other dermatitis (12,671/10,842), atopic dermatitis (AD) (11,421/9,734), and herpes zoster (26,249/9,652). With an average length of stay of 5.69 days, dermatology hospitals were in the bottom third. The proportion of inpatient indications cared for in dermatology hospitals was highest for prurigo (95.2 %), pemphigus (94.9 %), parapsoriasis (94.6 %), pemphigoid (90.3 %), eczema other than AD (85.6 %), and AD (85.2 %). While the total number of inpatient treatment cases in Germany has increased by an average of 17.5 % between 2000 and 2018, this is the case for 26.6 % of skin diseases and over 150 % for individual ones. The projection of current to future inpatient care suggests a continued high demand for inpatient care by dermatology hospitals. Conclusion Inpatient dermatological care will continue to be an indispensable component of qualified, socially necessary care in Germany.

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Inpatient care for skin diseases in Germany: multi‐source analysis on the current and future health care needs

Augustin

Kis

et al. 2021

Self Cite

“…For these, it is true that both the outpatient and inpatient sectors currently have, and will recognizably continue to have, an increasing need for care in the future. However, there is still a clear heterogeneity in the structures of care, which was already stated in the publication of 2013) for all dermatological UC and which concerned the clinic size as well as the service focus and the output (CM, CMI) [9]. However, all clinics had in common that compared to the periods of these publications, in the current period (2019), a significant reduction of the mean inpatient treatment time as well as a once again higher number of cases was found in the university facilities.…”

Section: Discussionmentioning

confidence: 99%

“…(2014) for the clinics of the DRG (Diagnosis Related Groups) benchmark and in Beikert et al. (2013) for all dermatological UC and which concerned the clinic size as well as the service focus and the output (CM, CMI) [9]. However, all clinics had in common that compared to the periods of these publications, in the current period (2019), a significant reduction of the mean inpatient treatment time as well as a once again higher number of cases was found in the university facilities.…”

Section: Discussionmentioning

confidence: 99%

Structures and performance characteristics of dermatology hospitals in Germany. Current status and long‐term development

Biedermann

Hertl³

et al. 2021

Summary Background The objective of the study was to characterize the performance of German dermatology hospitals. Methods A structured survey questionnaire was sent out to all dermatology hospitals in October 2019 as part of a cross‐sectional analysis based on health care research. Results Of the 115 hospitals, 95 (82.6 %) responded, including 34 (35.8 %) university hospitals (UC) and 61 (64.2 %) non‐university hospitals (NUC), of which 78 % were urban (43 % UC, 57 % NUC) and 22 % rural (10 % UC, 90 % NUC). The dermatology departments comprised an average of 45 inpatient and 11 day‐care beds (UC: 52/13, NUC: 40/9). An average of 2,302 inpatients were cared for in 2018 (UC: 2,874, NUC: 1,983), and the case mix index was 0.76 (UC: 0.74, NUC: 0.77, overall range: 0.40–0.96). Mean length of stay was 5.5 days for UC, relevantly lower than 2013 (5.9 days) and 2011 (7.1 days) data, and also significantly lower for NUC at 5.9 (2018) versus 5.1 days (2013). Conclusions German dermatology hospitals continue to have a high volume of inpatient care, with a comparison of the last six years again showing a compression with shorter length of stay and higher occupancy density. Dermatological hospitals represent an essential pillar of dermatological care.

“…(2014) für die Kliniken des DRG (diagnosebezogene Fallgruppe)‐Benchmarks sowie bei Beikert et al. (2013) für alle dermatologischen UK konstatiert wurde und sowohl die Klinikgröße wie auch die Leistungsschwerpunkte und den Output (CM, CMI) betraf [9]. Allen Kliniken ist aber gemein, dass sich im Vergleich zu den Gültigkeitsperioden dieser Publikationen in der Zwischenzeit (2019) eine deutliche Verringerung der mittleren stationären Behandlungszeit sowie eine nochmals höhere Fallzahl in den universitären Einrichtungen fand.…”

Section: Diskussionunclassified

Strukturen und Leistungsmerkmale der Hautkliniken in Deutschland: Aktuelle Bestandsaufnahme und Langzeitverlauf

Biedermann

Hertl

et al. 2021

Zusammenfassung Hintergrund Zielsetzung der Studie war die Charakterisierung der Leistungsdaten der deutschen Hautkliniken. Methoden Im Zuge einer versorgungswissenschaftlichen Querschnittsanalyse wurde im Oktober 2019 ein strukturierter Erhebungsbogen an alle Hautkliniken ausgesendet. Ergebnisse Von den 115 Kliniken antworteten 95 (82,6 %), davon 34 (35,8 %) Universitätskliniken (UK) und 61 (64,2 %) nicht universitäre Kliniken (NUK), davon 78 % aus dem städtischen (43 % UK, 57 % NUK) und 22 % aus dem ländlichen Raum (10 % UK, 90 % NUK). Die dermatologischen Abteilungen umfassten durchschnittlich 45 stationäre und 11 teilstationäre Betten (UK: 52/13, NUK: 40/9). Versorgt wurden 2018 durchschnittlich 2302 stationäre Patienten (UK: 2874, NUK: 1983), der Case‐Mix‐Index lag bei 0,76 (UK: 0,74, NUK: 0,77, gesamter Bereich: 0,40–0,96). Die mittlere Liegedauer lag bei den UK mit 5,5 Tagen relevant unter den Daten von 2013 (5,9 Tage) und 2011 (7,1 Tage), bei den NUK mit 5,9 (2018) versus 5,1 Tagen (2013) ebenfalls signifikant niedriger. Schlussfolgerungen Die deutschen Hautkliniken weisen nach wie vor ein hohes Aufkommen an stationärer Versorgungsleistung auf, bei dem sich im Vergleich der letzten sechs Jahre nochmals eine Verdichtung mit kürzerer Liegedauer und höherer Belegungsdichte zeigte. Hautkliniken stellen eine essenzielle Säule der dermatologischen Versorgung dar.