Abstract:
BACKGROUND:Reimbursement of inpatient treatment by daily constant charges is replaced by diagnosis- and procedure-related group system (G-DRG) in German acute care hospitals excerpt for psychiatry since 2004. Re-designs of G-DRG system were undertaken in 2005 and 2006. Parallel to implementation requirement- and resource-based self-adjustment of this new reimbursement system has been established by law. Adjustments performed in 2005 and 2006 are examined with respect to their effect on reimbursements in treatments of children with oncological, hematological, and immunological diseases. PATIENTS AND METHODS:An unchanged population of 349 patients associated with 1,731 inpatient stays of a Clinic of Pediatric Oncology, Hematology, and Immunology in 2004 was analyzed by methods and means of G-DRG systems 2004, 2005, and 2006. DRGs and additional payments for drugs and procedures eligible for all and/or individual hospitals were calculated. RESULTS:G-DRG system 2005 resulted in overall reimbursement loss of 3.77 % compared to G-DRG 2004. G-DRG 2006 leads to slightly improved overall reimbursements compared to G-DRG 2005 by increasing DRG-based revenues. G-DRG 2006 effects 2.40 % reduction in overall reimbursement compared to G-DRG 2004. This loss includes ameliorating effects of additional payments for drugs and blood products already. Despite introduction of additional payments especially designed for children and teenagers in 2006, additional payment volume is decreased by 21.71 % from 2005 to 2006. G-DRG 2006 yields over-all reimbursement losses of 1.45 % in comparison to G-DRG 2004. Overall reimbursements include introduced additional payments for drugs and blood products. (Reimbursements resulting out of DRG payment alone drop by 14.73 % from 2004 to 2005, and increase by 3.26 % from 2005 to 2006 (2004 vs. 2006 11.95 %). Introduction of additional payments for drugs and blood products on a Germany-wide basis introduced in 2005 dampens DRG-based reimbursement losses. Despite introduction of dosage intervals specifically designed for children and adolescents in 2006, reimbursement of additional payments for drugs and blood products decrease by 21.71 % from 2005 to 2006. An important revenue-balancing function is attributed to additional charges individual for each hospital according to Par. 6 Section 2 (New diagnostic and therapeutic methods) and Section 2 a KHEntgG (German Hospital Reimbursement Law) with respect to financing tertiary care focusses. If possible to attain, those charges may partially equalize losses. Including these additional charges per individual hospital balance of summarized additional charges is -3.89 % from 2005 to 2006. However, fraction of additional payments on total reimbursements increases from 0.64 % in 2004 to 11.98 % in 2005, and 11.24 % in 2006, respectively. CONCLUSIONS:The G-DRG system in its versions 2005 and 2006 results in lowering overall reimbursements of a pediatric hematology, oncology, and immunology department compared to initial status in 2004. The growing chargeability of additional payments ameliorate this effect.
journal_name
Klin Padiatrjournal_title
Klinische Padiatrieauthors
Christaras A,Schaper J,Strelow H,Laws HJ,Göbel Udoi
10.1055/s-2006-942274subject
Has Abstractpub_date
2006-11-01 00:00:00pages
366-78issue
6eissn
0300-8630issn
1439-3824journal_volume
218pub_type
杂志文章abstract:BACKGROUND:Late effects become progressively more important for the evaluation of therapeutic success in paediatric oncology. Thus, in 1998, the Late Effects Surveillance System (LESS) started to register and assess multicentrally, prospectively and longitudinally late effects of treatment for the group of Ewing's, sof...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2005-836503
更新日期:2005-05-01 00:00:00
abstract::Internal hydrocephalus follows intraventricular hemorrhage in about 10%. Progression is directly related to the degree of hemorrhage. Several studies confirmed that cerebral damage may occur without an increase of intracranial pressure or head circumference. Assessment and therapeutic consequences depend entirely on s...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1033725
更新日期:1988-07-01 00:00:00
abstract::Newly diagnosed immune thrombocytopenia occurs in 3-5/100 000 children < 14 y per year. Bleeding symptoms do not correlate with platelet count. Diagnostic approach includes history, clinical examination and analysis of blood count with blood smear by experienced hematologist. Additional investigations are only necessa...
journal_title:Klinische Padiatrie
pub_type: 共识发展会议,杂志文章
doi:10.1055/s-0032-1306277
更新日期:2012-04-01 00:00:00
abstract::According to the theories of Schachter concerning the external response of obese adults, which have been confirmed by Jung, Pudel and Nisbett, we tested these theories in obese adolescents. Eating behaviour of 16 grossly obese adolescents (8 males, 8 females, mean age 13.2 +/- 0.3 years, mean relative body weight 124 ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2007-1025512
更新日期:1990-05-01 00:00:00
abstract::Possibilities of recognizing cerebral function disturbances in newborns as early as the acute phase of the condition, and of prognosticating permanent brain damage are described. Clinical findings such as lethargy or spasms in the second and third weeks of life following hypoxia indicate severe function disturbances w...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1034092
更新日期:1984-11-01 00:00:00
abstract::Wegener's granulomatosis is together with Churg-Strauss syndrome and microscopic polyangiitis a very rare cause of hemoptysis in childhood. We report on a 14 years old girl who developed arthralgia, purpura, glomerulonephritis and a diffuse alveolar haemorrhage with hemoptysis after a short time period of unspecific s...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2005-836847
更新日期:2006-01-01 00:00:00
abstract::Concentrations of free thyroxine (n = 341, male = 205, female = 136) and free triiodothyronine (n = 318, male = 198, female = 120) were determined using the radioimmunoassay method in blood serum of euthyroid children. Beyond the 30. day of life no significant differences were found in different age groups for the fre...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1026821
更新日期:1987-09-01 00:00:00
abstract:BACKGROUND:Thyroglossal duct cysts arise from mucus production in an incomplete regressed thyroglossal duct. Often they are only noticed in case of infection or secondary fistulation. The operative management is a Sistrunk procedure. METHOD AND PATIENTS:In a retrospective study we analyse 26 patients aged 0,3 - 10 yea...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2001-17223
更新日期:2001-09-01 00:00:00
abstract::Severe anaphylactic reactions were observed in 2 children, aged 2 and 14 years, with acute lymphocytic leukemia and a 12 month old infant with a functional T-cell defect after intravenous administration of a polyethyleneglycol (PEG)-treated immunoglobulin preparation. All 3 children suffered additionally from hypogamm...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1026802
更新日期:1987-07-01 00:00:00
abstract::Prognostic factors to estimate the risk of relapse are crucial for risk-adapted therapy in acute lymphoblastic leukemia (ALL). In a cooperative multicenter treatment study for childhood ALL (COALL-03-85) the prognostic relevance of the bone marrow (BM) blast count at day 28 was evaluated. Treatment was adjusted to the...
journal_title:Klinische Padiatrie
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1055/s-2007-1025434
更新日期:1991-07-01 00:00:00
abstract::In our experience the prognosis of hematological relapse in patients with acute lymphatic leukemia treated according to the Pinkel programme is very bad. It may be a little better for patients in whom relapse occurred after the end of therapy and who were submitted to intensified cytostatic treatment. The chances for ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::Bacterial endocarditis belongs to the rare diseases in childhood. It occurs usually as a single episode and almost exclusively in children with congenital heart disease. In recent years, however, an increased number of renewed endocarditis after the first episode were reported, especially in drug addicts. We present a...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1046498
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Modern neonatal and pediatric intensive care includes a sophisticated pharmacotherapy with numerous drugs, mainly administered intravenously. Often, despite the use of multi-lumen central venous lines, more peripheral venous accesses are required. To reduce the necessity of numerous venous lines on one hand ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2005-836937
更新日期:2007-01-01 00:00:00
abstract::We report on a male premature infant with hypoplastic abdominal wall musculature, urinary tract anomalies and kryptorchism--the main features of Prune-Belly-syndrome. Furthermore the patient showed cardiac anomalies, urinary tract anomalies, limb defects, vertebral anomalies and anal atresia, which belong to the main ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract::Report on a case of acute childhood leukemia, who presents with the following exceptional features: During complete remission early bilateral leukemic infiltrations of the testes, followed--after an intervall of several months--by a serve, general relapse with ascites. New induction therapy resulted in a second comple...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract:BACKGROUND:Supraventricular reentrant tachycardias are the most common cardiac arrhythmia observed in infancy and childhood. The often benign clinical course of the disease warrants careful selection of any antiarrhythmic drug given to prevent recurrencies, in order to avoid potentially dangerous side-effects such as p...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1043903
更新日期:1998-09-01 00:00:00
abstract::The increasing importance of radiotherapy in tumor of childhood demands the investigation and consideration of the psychological aspects of this afflicting therapy. In this paper the results obtained by questioning and observing 28 children of different ages, their parents, attendants and employees of several radiolog...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1034457
更新日期:1981-05-01 00:00:00
abstract::The aetiology and pathogenesis of the Duchenne-type muscular dystrophy (pseudohypertrophic muscular dystrophy) are still largely unknown. The possibilities of treating the disease are rather limited. Treatment is the more successful, the earlier diagnosis was possible, and the earlier treatment is initiated. The CK-Sc...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,评审
doi:
更新日期:1978-11-01 00:00:00
abstract::The article reports on a case of visceral leishmaniasis in a 3-year-old child of German residents in Rome who had passed two vacations on the isle of Ischia. Initial signs were intermittent temperatures, marked anorexia, hepatosplenomegaly and pancytopenia, with spontaneous recovery after three weeks. At that time, le...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1979-05-01 00:00:00
abstract::The diagnosis of HFI is easily missed during childhood. It should be suspected in children presenting with hepatomegaly and an isolated increase in GGT. A carefully taken nutritional history forms the basis of the diagnosis of HFI which can be confirmed by molecular analysis with a sensitivity of > 95%. I.v. fructose ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:2000-05-01 00:00:00
abstract::The investigation of Immunoglobulins-and Total protein concentrations in saliva of healthy children shows an agreement with literature, a maturation in individual development of the saliva-producing organs in the mouth. ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1035623
更新日期:1980-09-01 00:00:00
abstract::Within the scope of an observation study 40 premature low birth weight infants requiring parenteral nutrition received either 10% or 20% lipid emulsions (Lipovenös) for 7 days. The 10% lipid emulsion differs from the 20% lipid emulsion in the higher phospholipid/triglyceride-ratio (0.06 resp. 0.12). Lipid infusion was...
journal_title:Klinische Padiatrie
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1055/s-2007-1025318
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Sonographic screening helps to discover pathological findings in asymptomatic patients. In these cases the decision about diagnostic and therapeutic consequences is difficult. CASE REPORT:We describe a girl with a congenital small solitary hepatic cyst with rapidly increasing size after the second year, whi...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2002-35364
更新日期:2002-11-01 00:00:00
abstract::A paralysis of the left vocal cord was seen by laryngoscopy in a 3-days-old boy with inspiratory stridor. A ductus aneurysm was established by angiocardiography, which was believed to be the cause of the vocal cord paralysis. Within 8 days after the angiocardiography the aneurysm became smaller and the stridor disappe...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1026854
更新日期:1986-01-01 00:00:00
abstract::Crohn's Disease and Ulcerative Colitis play a vital role in the differential diagnosis of inflammatory diseases of the colon during childhood. Pediatricians, radiologists, pediatric surgions and pediatric pathologists have been frequently confronted with the problem of distinguishing the two diseases. Morphologically,...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1978-03-01 00:00:00
abstract::Neurological symptoms developed in a girl aged three-and-a-half years during treatment with nalidixic acid. The symptoms progressed even after the preparation had been discontinued, and culminated in the development of a transient intracranial pressure increase. ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1979-07-01 00:00:00
abstract::Background: Diabetes mellitus is a common endocrinopathy in patients with thalassemia major, but the occurrence of hemoglobinopathies is rare in Germany and Western Europe. The longitudinal German-Austrian DPV (Diabetes Patienten Verlaufsdokumentation) registry allows a comprehensive characterization of this group of ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-0042-111691
更新日期:2016-11-01 00:00:00
abstract::Oncological diseases in children and adolescents represent a considerable burden for the children themselves and for their families. In order to position such concomitants of a life-threatening disease appropriately among the diagnostic options of psychosocial cancer care one is repeatedly confronted with the issue of...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2007-985872
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to evaluate paediatric reference values for platelet function using a point-of-care whole blood impedance aggregometry. METHODS, RESULTS & CONCLUSION: In 265 healthy infants and children aged journal_title:Klinische Padiatrie pub_type: 杂志文章 doi:10.1055/s-0030-1249081 更新日期:2010-05-01 00:00:00
abstract:BACKGROUND: Despite a reduction in hospitalizations due to acute alcohol intoxication in minors, alcohol consumption among children and adolescents still presents an alarming social and clinical phenomenon. This is amplified by presumably more severe clinical symptoms of the alcohol intoxication in children and adoles...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/a-1186-2155
更新日期:2020-09-01 00:00:00