Documentation, Calculation and Process Analysis in the age of DRGs: Computerized Support in the Hospital

Josef Ingenerf, Frederik Gerdsen, Bettina Seik, Siegfried Pöppl, Raphael Schreiber, Anne-Kathrin Heinemeier, Karsten Köppe, Hans-Peter Bruch


The introduction of the G-DRGs (German Diagnosis Related Groups) in the year 2002 and the gradual use as a reimbursement system beginning from 2005 forces hospitals to meet enormous challenges with respect to organizational and IT-issues. The quality of the basic data set in terms of case and data completeness, accuracy and timeliness has to be ensured because with that the DRG case group and hence, the associated revenue is determined. From the economic point of view the costs of providing the corresponding health care services are of interest. These are determined by cost-unit accounting based on the mentioned patient and case related data and furthermore, on performance and cost data. Especially the latter data is available in a distributed and heterogeneous hospital information system and has to be integrated technically, syntactically and semantically by suitable mechanisms.

Considering the IT infrastructure of the hospital "Universitätsklinikum Schleswig-Holstein, Campus Lübeck" suitable software systems supporting the mentioned tasks have been developed that are described in this paper, referring to one continuous example. As the G-DRG-system is subject to running modifications self-developed software regarding house-specific knowledge is needed. This is true as long as commercial supplied software systems are functionally unsatisfying and not flexible enough, especially with respect to interfaces to other software systems. Usually tools for analyzing costs are in the focus of financial controllers. The same data can be used by physicians for analyzing the delivery of healthcare. Based on the detailed data underlying the cost accounting the individual healthcare process from admission to discharge can be analyzed, e.g. what is done for the patient diagnostically and therapeutically? The case data can be aggregated and can be compared with available grouped and calculated data on a national basis; the data set of the German DRG institute (InEK). An insight into the characteristics of the own actual health care processes can improve the next step of defining target processes or clinical paths.
Original languageGerman
JournalGMS Medizinische Informatik, Biometrie und Epidemiologie
Publication statusPublished - 07.04.2005

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