Traduction en anglais : Rationale of inpatient care : towards a new payment system.
System : German statutory health insurance is introducing a system of lump sum payments for hospital care in the framework of a sectoral budget.
All hospital cases covered by a major regional health insurance fund (AOK Magdeburg) and completed in 1995 to 1997 (590,000 cases and 7.6 million hospital days, resp.) were analysed to find out changes in the main parameters of inpatient care.
The number of hospital cases per 10,000 insured persons continues to increase even after age-adjustment.
The increase was 3.1% from 1996 to 1997.
Hence the objective « outpatient treatment ranks before inpatient treatment » has not been achieved.
The number of hospital days per 10,000 insured patients also increased.
Hence the concept of « controlled touch down » (i.e. reaching the prospectively negotiated number of hospital days exactly) has not succeeded.
After taking age into account, the number of hospital days slightly and for the first time decreased in 1997 compared to 1996.
The average level of hospital stay (LOS) is decreasing, but still high.
The proportion of cases with hospital stays exceeding the « Length of Stay Guidelines » was more than 30% in 1997.
The pattern of the three parameters (number of cases, hospital days, and LOS) indicate that hospitals manage bed occupancy rates in the first place and that the indications for in-patient treatment are getting softer.
Between 1996 and 1997 there has been a 17.5% increase in the total number of cases reimbursed by lump sums. (...)
Mots-clés Pascal : Assurance maladie, Protection sociale, Système santé, Service santé, Service hospitalier, Soin, Milieu hospitalier, Analyse coût, Homme, Allemagne, Europe
Mots-clés Pascal anglais : Health insurance, Welfare aids, Health system, Health service, Hospital ward, Care, Hospital environment, Cost analysis, Human, Germany, Europe
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0176097
Code Inist : 002B30A01B. Création : 16/11/1999.