Content area
Full Text
J Neurol (2011) 258:19291932 DOI 10.1007/s00415-011-6032-y
ORIGINAL COMMUNICATION
From the stroke unit to the stroke competence center: corresponding benecial clinical and nancial effects
A. Chatzikonstantinou A. Frster
M. G. Hennerici H. Bazner
Received: 8 October 2010 / Revised: 18 January 2011 / Accepted: 24 March 2011 / Published online: 6 April 2011 Springer-Verlag 2011
Abstract The introduction of the diagnosis related groups (DRG) system in Germany has radically inuenced the organization of in-hospital patient treatment. Case-mix-index and duration of treatment in a stroke unit (SU) play a central role. Our SU started in 1998 and was gradually extended to the current Stroke Competence Center (SCC), with a total capacity of 29 patients. The SCC combines acute treatment, work-up and post-stroke management by the same specialized team. We aimed primarily at demonstrating the nancial effects of this concept. Data from stroke patients treated in our SU/SCC between 2004 and 2009 were analyzed. We analyzed the number of treated stroke patients, number of thrombolytic treatments, the number of cases coded with procedure codes OPS 8-981.x and the ratio of OPS 8-981.0 (2472 h on SU) to the higher remunerated OPS 8-981.1 ([72 h on SU). The number of treated patients increased by 118.3% (from 469 in 2004 to 1024 in 2009). The number of thrombolyses per year has more than quadrupled (2004: 46, 2009: 253, i.e. 25% of SU patients). The introduction of the stroke center concept lead to a great increase in the ratio of the higher rewarded OPS 8-981.1 to OPS 8-981.0 (from 1.5 in 2005 to5.21 in 2009). Our data demonstrates that the SCC concept leads to a greater nancial potential, while offering considerable medical advantages concerning more effective stroke treatment and work-up as well as improved ow of
information and enhanced individual patient-physician relationship.
Keywords Stroke Unit Stroke management
Diagnosis related groups
Introduction
The introduction of the diagnosis related groups (DRG) system in Germany and its modication into a case-based lump sum system has radically inuenced the organization of in-hospital patient treatment. Since the nancial reward depends mainly on the case-mix of each patient and not on the time requested for hospitalization, case and discharge management play a crucial role for the economics of the respective hospital.
DRG is a system used to...