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Rehabilitation (Stuttg) ; 50(4): 214-21, 2011 Aug.
Article in German | MEDLINE | ID: mdl-21800267

ABSTRACT

The REDIA study is the only long-term (2003-2009), prospective, multicentre study analyzing the impact of the DRG system on quality and costs in rehabilitation facilities. In 2004, Diagnosis Related Groups (DRG) were implemented on a mandatory basis in the German healthcare system as a reimbursement scheme for hospitals based on administered prices for procedures. Experiences from other countries revealed that introduction of DRG does not only have a significant impact on hospitals but also on rehabilitation facilities. The study approach ensures a comprehensive analysis as it considers major clinical, therapeutic, psychological and economic aspects. The REDIA study is the only nationwide empirical study that includes all stages of the implementation process: before DRG implementation, during the convergence phase and following implementation. An indication-specific comparison of the phases showed significantly shorter stays in the acute sector as well as shorter transition times between the sectors, resulting in admission of patients into rehabilitative care at an earlier stage of their recovery process. Significant diversions of treatment efforts from the acute sector to the rehabilitative sector have been proven in terms of increased nursing efforts and potential changes in the therapeutic and medical treatments to be provided.


Subject(s)
Diagnosis-Related Groups/economics , Diagnosis-Related Groups/legislation & jurisprudence , Fee-for-Service Plans/economics , Fee-for-Service Plans/legislation & jurisprudence , Length of Stay/economics , Length of Stay/legislation & jurisprudence , National Health Programs/economics , National Health Programs/legislation & jurisprudence , Rehabilitation Centers/economics , Rehabilitation Centers/legislation & jurisprudence , Arthroplasty, Replacement, Hip/economics , Arthroplasty, Replacement, Hip/rehabilitation , Arthroplasty, Replacement, Knee/economics , Arthroplasty, Replacement, Knee/rehabilitation , Convalescence , Coronary Artery Bypass/economics , Coronary Artery Bypass/rehabilitation , Cost Allocation , Delivery of Health Care/economics , Delivery of Health Care/legislation & jurisprudence , Female , Germany , Health Plan Implementation/economics , Health Plan Implementation/legislation & jurisprudence , Health Services Needs and Demand/economics , Health Services Needs and Demand/legislation & jurisprudence , Humans , Lumbar Vertebrae/surgery , Male , Middle Aged , Myocardial Infarction/economics , Myocardial Infarction/rehabilitation , Outcome and Process Assessment, Health Care , Patient Care Team/economics , Patient Care Team/legislation & jurisprudence , Rehabilitation Nursing/economics , Rehabilitation Nursing/legislation & jurisprudence , Spinal Diseases/economics , Spinal Diseases/rehabilitation
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