Background and objectives of the study
The discharge management and its related agreements, which came into force on October 1, 2017 was agreed by the German Hospital Association (DKG), the Federal Association of Statutory Health Insurance Funds (KBV), and the Central Association of Statutory Health Insurance Companies (GKV-Spitzenverband). It presented hospitals with structural, personnel and financial challenges. The study aims to determine the costs of discharge management in the Department of Surgery at the University Hospital Rechts der Isar of the Technical University of Munich, Germany, to assess the length of stay in comparison with and without discharge management, and to evaluate patients’ satisfaction to create first precedents for future negotiations about adequate financing.
Design and results
As part of the study design, a cost analysis of discharge management as well as a retrospective analysis of the mean length of hospital stays before and after implementation of discharge management was implemented. Furthermore, patient surveys on the quality of the structured transition process and their satisfaction were conducted.
The cost analysis revealed lump costs of €43 per patient and €391 for patients with a need for complex management. No statistically significant shorter length of hospital stay after the implementation of discharge management was found for three patient subgroups. The overall rate of patients returning to the hospital due to complications associated with the surgical procedure was 3.4%.
Implications
Discharge management was an effective and potentially quality-enhancing, but at the same time cost-driving measure, which, in the medium term, will enter G‑DRG (German Diagnosis Related Groups) rates and may thus increase costs. A possible solution to meet various stakeholders’ needs could be a case-specific financial remuneration of discharge management that is adapted to the transition qualities of the various medical departments.
Contact
Department of Sport and Health Management
Prof. Dr. Jörg Königstorfer
Uptown München Campus D
Georg-Brauchle-Ring 60/62
80992 München
Tel. +49.89.289.24558
Fax +49.89.289.24642
www.sg.tum.de/mgt