PMID- 17211776
OWN - NLM
STAT- MEDLINE
DCOM- 20070502
LR  - 20070212
IS  - 0937-2032 (Print)
IS  - 0937-2032 (Linking)
VI  - 57
IP  - 2
DP  - 2007 Feb
TI  - [Elevated costs of treatment in medical inpatients with psychiatric comorbidity 
      are not reflected in the German DRG-system].
PG  - 70-5
AB  - OBJECTIVE: So far, it remains unclear whether treatment of psychiatric 
      comorbidity in medical inpatients is appropriately reflected in the German 
      Diagnosis-Related Groups (DRG) system. Therefore, we investigated the 
      relationship of psychiatric disorders and costs, returns, net gain, and duration 
      of hospitalization in internal medicine inpatients. METHODS: For a period of 1 
      year, we analyzed costs, net gain and other outcome variables according to the 
      DRG system for all inpatients of a university department of internal and 
      psychosomatic medicine (n = 697). Psychiatric disorders were diagnosed by the 
      treating physicians based on clinical criteria and results from the Patient 
      Health Questionnaire (PHQ). With respect to the outcome variables, we compared 
      three groups of patients with none, one, and more than one psychiatric disorder 
      controlling for sociodemographic characteristics. RESULTS: The average total 
      costs of the hospitalization (M +/- SD) for internal medicine patients without 
      psychiatric comorbidity (4357 +/- 5312 euro), for patients with one psychiatric 
      disorder, (4733 +/- 5389 euro), and for patients with more than one psychiatric 
      disorder (7163 +/- 8277 euro) differed significantly (p = 0.0003). However, the 
      increased costs for patients with psychiatric comorbidity were not related to 
      elevated returns: the net gain for patients without psychiatric comorbidity was 
      457 +/- 2884 euro; in contrast, the treatment of internal medicine patients with 
      one and more than one psychiatric disorder resulted in a net loss of - 260 +/- 
      2389 euro and - 348 +/- 3370 euro, respectively (overall group difference, p = 
      0.03). CONCLUSIONS: Additional work and expenses caused by patients with 
      psychiatric comorbidity should be documented and reflected in the revenue 
      systems. Practical self-report screening questionnaires may help to detect and 
      treat psychiatric disorders in internal medicine inpatients as early as possible.
FAU - Hochlehnert, Achim
AU  - Hochlehnert A
AD  - Abteilung fur Psychosomatische und Allgemeine Klinische Medizin, 
      Universitatsklinikum Heidelberg. Achim_Hochlehnert@med.uni-heidelberg.de
FAU - Niehoff, Dorothea
AU  - Niehoff D
FAU - Herzog, Wolfgang
AU  - Herzog W
FAU - Lowe, Bernd
AU  - Lowe B
LA  - ger
PT  - English Abstract
PT  - Journal Article
TT  - Hohere Kosten bei internistischen Krankenhauspatienten mit psychischer 
      Komorbiditat: Fehlende Abbildung im DRG-System.
DEP - 20070108
PL  - Germany
TA  - Psychother Psychosom Med Psychol
JT  - Psychotherapie, Psychosomatik, medizinische Psychologie
JID - 8002823
SB  - IM
MH  - Adult
MH  - Aged
MH  - Comorbidity/*trends
MH  - Diagnosis-Related Groups/*economics/statistics & numerical data
MH  - Female
MH  - Germany
MH  - Hospitalization/economics
MH  - Humans
MH  - Inpatients/*statistics & numerical data
MH  - Length of Stay
MH  - Male
MH  - Mental Disorders/complications/*economics/therapy
MH  - Middle Aged
MH  - Research Design
MH  - Socioeconomic Factors
EDAT- 2007/01/11 09:00
MHDA- 2007/05/03 09:00
CRDT- 2007/01/11 09:00
PHST- 2007/01/11 09:00 [pubmed]
PHST- 2007/05/03 09:00 [medline]
PHST- 2007/01/11 09:00 [entrez]
AID - 10.1055/s-2006-951924 [doi]
PST - ppublish
SO  - Psychother Psychosom Med Psychol. 2007 Feb;57(2):70-5. doi: 
      10.1055/s-2006-951924. Epub 2007 Jan 8.