Interdisciplinary complex therapies in inpatient hospital treatment in Germany: Evidence from Germany

Romeyke, Tobias; Stummer, Harald

doi:10.1179/1753304x11y.0000000012

Cited by 8 publications

(11 citation statements)

References 11 publications

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“…Another study of Romeyke and Stummer [21] analyzed complex rheumatic treatment and similar to our study found a prolonged stay of patients without higher costs per day associated with this form of treatment. However that study used data from the beginning of the DRG calculation and reliability data was weak.…”

Section: Discussionsupporting

confidence: 89%

Cost Analysis of Integrative Inpatient Treatment Based on DRG Data: The Example of Anthroposophic Medicine

Heinz¹,

Fiori

Heusser

et al. 2013

Evidence-Based Complementary and Alternative Medicine

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Background. Much work has been done to evaluate the outcome of integrative inpatient treatment but scarcely the costs. This paper evaluates the costs for inpatient treatment in three anthroposophic hospitals (AHs). Material and Methods. Cost and performance data from a total of 23,180 cases were analyzed and compared to national reference data. Subgroup analysis was performed between the cases with and without anthroposophic medical complex (AMC) treatment. Results. Costs and length of stay in the cases without AMC displayed no relevant differences compared to the national reference data. In contrast the inlier cases with AMC caused an average of € 1,394 more costs. However costs per diem were not higher than those in the national reference data. Hence, the delivery of AMC was associated with a prolonged length of stay. 46.6% of the cases with AMC were high outliers. Only 10.6% of the inlier cases with AMC were discharged before reaching the mean length of stay of each DRG. Discussion. Treatment in an AH is not generally associated with an increased use of resources. However, the provision of AMC leads to a prolonged length of stay and cannot be adequately reimbursed by the current G-DRG system. Due to the heterogeneity of the patient population, an additional payment should be negotiated individually.

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Section: Discussionsupporting

confidence: 89%

Cost Analysis of Integrative Inpatient Treatment Based on DRG Data: The Example of Anthroposophic Medicine

Heinz¹,

Fiori

Heusser

et al. 2013

Evidence-Based Complementary and Alternative Medicine

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“…The average age of the patients in this study also corresponds to the reported results of other investigations 16,40. Length of inpatient stay was dependent on the diagnose(s) and the targets according to the G-DRG, and comparable to those of other studies and those of the calculation institute 26. As already established in other scientific studies, anxiety and depression are common concomitant diseases 40,41.…”

Section: Discussionsupporting

confidence: 89%

“…These are shown in Table 1, and are checked for after being diagnosed with FMS. All patients included in the present study were surveyed as per these criteria to determine the severity of the illness and thus the necessity of inpatient treatment 26. Only patients who fulfilled all criteria, thereby qualifying for inpatient treatment, were included in the standardized cost calculation.…”

Section: Methodsmentioning

confidence: 99%

Severe forms of fibromyalgia with acute exacerbation of pain: costs, comorbidities, and length of stay in inpatient care

Romeyke¹,

Nöhammer²,

Scheuer³

et al. 2017

CEOR

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Background and purposeAs a disease of the musculoskeletal system, fibromyalgia is becoming increasingly important, because of the direct and indirect costs to health systems. The purpose of this study of health economics was to obtain information about staff costs differentiated by service provider, and staff and material costs of the nonmedical infrastructure in inpatient care.Patients and methodsThis study looked at 263 patients who received interdisciplinary inpatient treatment for severe forms of fibromyalgia with acute exacerbation of pain between 2011 and 2014. Standardized cost accounting and an analysis of additional diagnoses were performed.ResultsThe average cost per patient was €3,725.84, with staff and material costs of the nonmedical infrastructure and staff costs of doctors and nurses accounting for the highest proportions of the costs. Each fibromyalgia patient had an average of 6.1 additional diagnoses.ConclusionSevere forms of fibromyalgia are accompanied by many concomitant diseases and associated with both high clinical staff costs and high medical and nonmedical infrastructure costs. Indication-based cost calculations provide important information for health policy and hospital managers if they include all elements that incur costs in both a differentiated and standardized way.

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“…The individual disciplines are also included at the interdisciplinary team meeting, which takes place every week. In the course of the meeting, therapeutic targets are formulated and evaluated and the treatment progression examined and documented, 30 which can be reflected in higher costs.…”

Section: Discussionmentioning

confidence: 99%

Inpatient hospital costs and length of stay for the treatment of affective and somatoform disorders – evidence from Germany

Romeyke¹,

Scheuer

Stummer

2014

RMHP

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IntroductionDiagnosis related costs analyses are the subject of science and research and are of great relevance and importance for decision makers in the hospital and for funding bodies, but also for international health policy. Up to now, standardized costs analyses with valid costs data have not been available for inpatient care of patients with affective and somatoform disorders.BackgroundThis clinical picture presents a major challenge for the provision of outpatient and inpatient care. An interdisciplinary approach in an inpatient setting can be beneficial for already “chronified” patients with severe forms of progression. Because of its structural and procedural demands, this type of care is associated with a greater expenditure of resources.MethodsCosts data from the years 2008 to 2012 were analyzed for a total of 17,424 hospitalized patients in more than 200 different hospitals in Germany. The study compared the costs of treating patients with the main diagnosis affective and somatoform disorders using standardized interdisciplinary therapy, with the costs of conventional therapy.ResultsInterdisciplinary patient care is characterized by a high proportion of the costs derived from the structural and procedural implementation and the medical and nursing care. For interdisciplinary therapy with a mean period of hospitalization of 15.2 days, over 60% of the total costs were incurred by the personnel and material costs of the medical and non-medical infrastructure. The outlay is considerably greater than would be incurred by a conventional therapeutic approach without interdisciplinary therapy.Discussion and conclusionFor the first time, detailed diagnosis-related costs data are published which were generated by consistent, standardized cost unit accounting. An interdisciplinary, holistic approach to the clinical picture results in a significant increase in costs for the hospitals.

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Interdisciplinary complex therapies in inpatient hospital treatment in Germany: Evidence from Germany

Cited by 8 publications

References 11 publications

Cost Analysis of Integrative Inpatient Treatment Based on DRG Data: The Example of Anthroposophic Medicine

Cost Analysis of Integrative Inpatient Treatment Based on DRG Data: The Example of Anthroposophic Medicine

Severe forms of fibromyalgia with acute exacerbation of pain: costs, comorbidities, and length of stay in inpatient care

Inpatient hospital costs and length of stay for the treatment of affective and somatoform disorders – evidence from Germany

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Interdisciplinary complex therapies in inpatient hospital treatment in Germany: Evidence from Germany

Cited by 8 publications

References 11 publications

Cost Analysis of Integrative Inpatient Treatment Based on DRG Data: The Example of Anthroposophic Medicine

Cost Analysis of Integrative Inpatient Treatment Based on DRG Data: The Example of Anthroposophic Medicine

Severe forms of fibromyalgia with acute exacerbation of pain: costs, comorbidities, and length of stay in inpatient care

Inpatient hospital costs and length of stay for the treatment of affective and somatoform disorders &ndash; evidence from Germany

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Inpatient hospital costs and length of stay for the treatment of affective and somatoform disorders – evidence from Germany