Einheitlichkeit der richtlinienkonformen Begutachtung durch den Medizinischen Dienst der Krankenversicherung bei der Prüfung der Kodierung im G-DRG-System

Gaertner, Thomas; Lehr, Frauke; Blum, B.; Essen, J. van

doi:10.1055/s-0034-1398553

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…Zur Sicherstellung der geforderten Qualität der stationären Versorgung übernimmt der MDK im Auftrag der gesetzlichen Krankenkassen sowie ihrer Verbände auf der Grundlage des § 275 SGB V sowie des § 17c KHG im Allgemeinen sozialmedizinische Sachverständigenaufgaben folgender Kategorien [10,11]: ▪ Begutachtungen von Versicherten (z. B. Einzelfallbegutachtungen zur G-DRG-Kodierqualität [12,13] und anlässlich Behandlungsfehlervorwürfen [14])…”

Section: Sozialgesetzliche Grundlagen Derunclassified

Qualitätsprüfungen in Krankenhäusern durch den MDK Hessen: Erfahrungen und Ausblick - ein Praxisbericht

et al. 2017

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Section: Sozialgesetzliche Grundlagen Derunclassified

Qualitätsprüfungen in Krankenhäusern durch den MDK Hessen: Erfahrungen und Ausblick - ein Praxisbericht

et al. 2017

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“…We cannot directly ensure coding quality as such. Yet, coding accuracy is monitored by the professional medical service to the statutory health insurance, which reviews about 10% of all insurance claims [28, 29]. Another limitation comes from the DRG system itself, which does not allow for a detailed resolution of ILDs regarding their aetiology since the ICD code J84.1 comprises diverse entities most prominently but not exclusively IPF.…”

Section: Discussionmentioning

confidence: 99%

“…As previously described, nationwide health insurance claims of the entire inpatient sample were obtained from the Federal Statistical Office of Germany (DeStatis) (Source: DOI:10.21242/23141.2005.00.00.1.1.0 to 10.21242/23141.2015.00.00.1.1.0, own calculations) [27]. DeStatis holds data according to the international classification of diseases, version 10 (ICD-10) data (German modification of the diagnosis related groups, G-DRG) [28, 29]. Data were aggregated and analysed using SAS 9.4 (SAS Institute, Cary, USA).…”

Section: Methodsmentioning

confidence: 99%

Interstitial Lung Disease: Seasonality of Hospitalizations and In-Hospital Mortality 2005–2015

et al. 2021

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Background: The overall incidence of interstitial lung disease and disease-associated mortality have been found on the rise. Hospitalizations for interstitial lung disease are typically caused by airway infection or the acute exacerbation of the underlying disease. Seasonal variance in ambient air pollution has recently been linked to exacerbation and mortality. We sought to examine the seasonal pattern of hospitalizations in Germany, use of mechanical ventilation, and in-hospital mortality on a year-by-year basis to identify their overall trend and to characterize seasonal patterns. Methods: The national in-patient database of the federal statistical office of Germany was searched for cases of interstitial lung disease. Results: A total of 130,366 hospitalizations for ILD occurred from 2005 to 2015. Time series data were examined for seasonality using X-11 statistics. The incidence of hospitalizations, mechanical ventilation, and in-hospital mortality show clear seasonal peaks in the cold season. The observed seasonality cannot be attributed to the variance of selected comorbidities. Also, there is a significant overall upward trend regarding hospitalization counts, especially in the use of non-invasive ventilation. Conclusion: Time series analysis of in-hospital data shows an ILD-related rise of hospitalizations, in-hospital mortality, and non-invasive ventilation. This emphasizes a growing importance of interstitial lung diseases for health-care systems. Strong seasonality is seen in these variables. Data therefore support previous studies of ILD exacerbation. More research on infectious causes and environmental factors is warranted.

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“…in den Sozialgesetzbüchern und regeln Ansprüche, Zuständigkeiten und Verfahrensweisen einer sozial motivierten gesellschaftlichen Daseinsfürsorge. Auch hier ist eine ordnende und klärende Wissenschaftlichkeit und eine diesbezüglich entwickelte Methodik für einen modernen Sozialstaat und seine unmittelbar oder mittelbar wahrgenommenen Steuerungsaufgaben unverzichtbar [22][23][24][25]. Zum Dritten eröffnet sich das schon angeklungene Feld der Bevölkerungsmedizin, welches in Deutschland nach den Verbrechen des nationalsozialistischen Unrechtregimes im Namen von Rassenhygiene und dem Dienst an einem "gesundem Volkskörper" mit weitgehender akademischer Abstinenz bis gegen Ende des 20.…”

Section: Gleichzeitig Ist Bei Dem Verweis Auf Kuration Rehabilitatiounclassified

Entwicklungslinien der Sozialmedizin und Öffentlichen Gesundheit in Deutschland

2016

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Social medicine in Germany has multiple lines of tradition, which are marked by the presence of 2 German states and their re-unification and by the (re-)establishment of multidisciplinary public health by the end of the twentieth century. At the same time, a differentiation within the applied fields of social medicine into several thematic topics can be observed. These can be grouped in a first step into the domains of clinical social medicine, of social medicine for social insurance purposes and of a population-oriented social medicine. For social medicine as a scientific discipline within the broad context of medicine, the requirement of a context-adequate development, which encompasses the special methods of multidisciplinary public health, poses big challenges. For successfully meeting these challenges and going beyond population-oriented public health and for bridging the gap between the individual and the social medical institutions of the health system, it is indispensable for social medicine to be independent of other disciplines within the array of medical specialties. The present study argues for strengthening social medicine within the medical faculties. Chairs for social medicine and public health are not only in the interest of the applied fields of social medicine, but represent also an indispensable scientific discipline which can relate and contribute to all specialties of medicine.

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Einheitlichkeit der richtlinienkonformen Begutachtung durch den Medizinischen Dienst der Krankenversicherung bei der Prüfung der Kodierung im G-DRG-System

Cited by 5 publications

References 8 publications

Qualitätsprüfungen in Krankenhäusern durch den MDK Hessen: Erfahrungen und Ausblick - ein Praxisbericht

Qualitätsprüfungen in Krankenhäusern durch den MDK Hessen: Erfahrungen und Ausblick - ein Praxisbericht

Interstitial Lung Disease: Seasonality of Hospitalizations and In-Hospital Mortality 2005–2015

Entwicklungslinien der Sozialmedizin und Öffentlichen Gesundheit in Deutschland

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