PMID- 24963880
OWN - NLM
STAT- MEDLINE
DCOM- 20150219
LR  - 20220310
IS  - 1424-3997 (Electronic)
IS  - 0036-7672 (Linking)
VI  - 144
DP  - 2014
TI  - Head-to-head comparison of length of stay, patients' outcome and satisfaction in 
      Switzerland before and after SwissDRG-Implementation in 2012 in 2012: an 
      observational study in two tertiary university centers.
PG  - w13972
LID - 10.4414/smw.2014.13972 [doi]
AB  - BACKGROUND: On 1 January 2012 Swiss Diagnosis Related Groups (DRG), a new uniform 
      payment system for in-patients was introduced in Switzerland with the intention 
      to replace a "cost-based" with a "case-based" reimbursement system to increase 
      efficiency. With the introduction of the new payment system we aim to answer 
      questions raised regarding length of stay as well as patients' outcome and 
      satisfaction. METHODS: This is a prospective, two-centre observational cohort 
      study with data from University Hospital Basel and the Cantonal Hospital Aarau, 
      Switzerland, from January to June 2011 and 2012, respectively. Consecutive 
      in-patients with the main diagnosis of either community-acquired pneumonia, 
      exacerbation of COPD, acute heart failure or hip fracture were included. A 
      questionnaire survey was sent out after discharge investigating changes before 
      and after SwissDRG implementation. Our primary endpoint was LOS. RESULTS: Of 
      1,983 eligible patients 841 returned the questionnaire and were included into the 
      analysis (429 in 2011, 412 in 2012). The median age was 76.7 years (50.8% male). 
      Patients in the two years were well balanced in regard to main diagnoses and 
      co-morbidities. Mean LOS in the overall patient population was 10.0 days and 
      comparable between the 2011 cohort and the 2012 cohort (9.7 vs 10.3; p = 0.43). 
      Overall satisfaction with care changed only slightly after introduction of 
      SwissDRG and remained high (89.0% vs 87.8%; p = 0.429). DISCUSSION: Investigating 
      the influence of the implementation of SwissDRG in 2012 regarding LOS patients' 
      outcome and satisfaction, we found no significant changes. However, we observed 
      some noteworthy trends, which should be monitored closely.
FAU - Thommen, Desiree
AU  - Thommen D
AD  - Division of Internal Medicine, University Hospital Basel, Switzerland.
FAU - Weissenberger, Noemi
AU  - Weissenberger N
AD  - Division of Internal Medicine, University Hospital Basel, Switzerland.
FAU - Schuetz, Philipp
AU  - Schuetz P
AD  - Division of Internal Medicine, Cantonal Hospital Aarau, Switzerland.
FAU - Mueller, Beat
AU  - Mueller B
AD  - Division of Internal Medicine, Cantonal Hospital Aarau, Switzerland.
FAU - Reemts, Christoph
AU  - Reemts C
AD  - Division of Medical Controlling, Cantonal Hospital Aarau, Switzerland.
FAU - Holler, Thomas
AU  - Holler T
AD  - Division of Medical Controlling, Cantonal Hospital Aarau, Switzerland.
FAU - Schifferli, Juerg A
AU  - Schifferli JA
AD  - Division of Internal Medicine, University Hospital Basel, Switzerland.
FAU - Gerber, Martin
AU  - Gerber M
AD  - Financial Department, University Hospital Basel, Switzerland.
FAU - Hug, Balthasar L
AU  - Hug BL
AD  - Division of Internal Medicine, University Hospital Basel, Switzerland.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20140625
PL  - Switzerland
TA  - Swiss Med Wkly
JT  - Swiss medical weekly
JID - 100970884
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Community-Acquired Infections/diagnosis/therapy
MH  - Diagnosis-Related Groups/*organization & administration
MH  - Female
MH  - Heart Failure/diagnosis/therapy
MH  - Hip Fractures/diagnosis/therapy
MH  - Hospitals, University/*trends
MH  - Humans
MH  - Length of Stay/*trends
MH  - Male
MH  - Patient Readmission/trends
MH  - Patient Satisfaction/*statistics & numerical data
MH  - Pneumonia/diagnosis/therapy
MH  - Prospective Studies
MH  - Pulmonary Disease, Chronic Obstructive/diagnosis/therapy
MH  - Surveys and Questionnaires
MH  - Switzerland
MH  - Tertiary Care Centers/*trends
MH  - Treatment Outcome
EDAT- 2014/06/26 06:00
MHDA- 2015/02/20 06:00
CRDT- 2014/06/26 06:00
PHST- 2014/06/26 06:00 [entrez]
PHST- 2014/06/26 06:00 [pubmed]
PHST- 2015/02/20 06:00 [medline]
AID - smw-13972 [pii]
AID - 10.4414/smw.2014.13972 [doi]
PST - epublish
SO  - Swiss Med Wkly. 2014 Jun 25;144:w13972. doi: 10.4414/smw.2014.13972. eCollection 
      2014.