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首页> 外文期刊>Journal of psychosomatic research >Introduction of DRG-based reimbursement in inpatient psychosomatics-an examination of cost homogeneity and cost predictors in the treatment of patients with eating disorders
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Introduction of DRG-based reimbursement in inpatient psychosomatics-an examination of cost homogeneity and cost predictors in the treatment of patients with eating disorders

机译：引入基于DRG的住院心理治疗费用报销-治疗饮食失调患者的费用均一性和费用预测因子检查

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Objective: Various western countries are focusing on the introduction of reimbursement based on diagnosis-related groups (DRG) in inpatient mental health. The aim of this study was to analyze if psychosomatic inpatients treated for eating disorders could be reimbursed by a common per diem rate. Methods: Inclusion criteria for patient selection (n= 256) were (1) a main diagnosis of anorexia nervosa (AN), bulimia nervosa (BN) or eating disorder-related obesity (OB), (2) minimum length of hospital stay of 2. days, (3) and treatment at Charité Universitaetsmedizin Berlin, Germany during the years 2006-2009. Cost calculation was executed from the hospital's perspective, mainly using micro-costing. Generalized linear models with Gamma error distribution and log link function were estimated with per diem costs as dependent variable, clinical and patient variables as well as treatment year as independent variables. Results: Mean costs/case for AN amounted to 5,251?, 95% CI [4407-6095], for BN to 3,265?, 95% CI [2921-3610] and for OB to 3,722?, 95% CI [4407-6095]. Mean costs/day over all patients amounted to 208?, 95% CI [198-218]. The diagnosis AN predicted higher costs in comparison to OB (p= 0009). A co-morbid personality disorder (p= 0442), every one-unit increase in BMI in OB patients (p= 0256), every one-unit decrease in BMI in AN patients (p= 0002) and every additional life year in BN patients (p= 0455) predicted increased costs. Conclusion: We see a need for refinements to take into account considerable variations in treatment costs between patients with eating disorders due to diagnosis, BMI, co-morbid personality disorder and age.
机译：目标：西方国家正在着重于引入基于诊断相关人群（DRG）的住院精神健康补偿。这项研究的目的是分析是否可以通过共同的每日津贴来补偿因饮食失调而接受治疗的心身病患者。方法：选择患者的纳入标准（n = 256）为（1）神经性厌食症（AN），神经性贪食症（BN）或饮食失调相关肥胖（OB）的主要诊断;（2）住院时间的最短2. 2006年至2009年，在德国柏林的CharitéUniversitaetsmedizin柏林大学进行为期2天的治疗。从医院的角度进行成本计算，主要使用微观成本核算。估计具有Gamma误差分布和对数链接功能的广义线性模型，每日津贴成本为因变量，临床和患者变量以及治疗年份为自变量。结果：AN的平均成本/案例为5,251？，CI为95％[4407-6095]，BN为3,265？，CI为95％[2921-3610]，OB为3,722？，95％CI [4407-6095] ]。所有患者每天的平均费用为208？，CI为95％[198-218]。诊断AN预计与OB相比，费用更高（p = 0009）。一种共病的人格障碍（p = 0442），OB患者的BMI每增加1个单位（p = 0256），AN患者的BMI每减少1个单位（p = 0002），以及BN的每增加一个生命年患者（p = 0455）预测费用增加。结论：我们认为有必要进行改进，以考虑到因诊断，BMI，合并症人格障碍和年龄导致的饮食失调患者之间治疗费用的巨大差异。

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