PMID- 33046108
OWN - NLM
STAT- MEDLINE
DCOM- 20210202
LR  - 20210202
IS  - 1472-6963 (Electronic)
IS  - 1472-6963 (Linking)
VI  - 20
IP  - 1
DP  - 2020 Oct 12
TI  - Comparative analysis of resource utilization in integrative anthroposophic and 
      all German pediatric inpatient departments.
PG  - 939
LID - 10.1186/s12913-020-05782-6 [doi]
LID - 939
AB  - BACKGROUND: Integrative Medicine (IM) combines conventional and complementary 
      therapies. It aims to address biological, psychological, social, spiritual and 
      environmental aspects of patients' health. During the past 20 years, the use and 
      request of IM in children and adults has grown. Anthroposophic Medicine (AM) is 
      an IM approach frequently used in children in Germany. From both public health 
      and health economic perspectives, it is relevant to investigate whether there are 
      differences in the resource utilization between integrative pediatric departments 
      (IPD) and the entirety of all pediatric departments. METHODS: Standard ward 
      documentation data from all German integrative anthroposophic pediatric 
      departments (2005-2016; N = 29,956) is investigated and systematically compared 
      to data of the entirety of all pediatric departments in Germany derived from the 
      Institute for the Hospital Reimbursement System (2005-2016, N = 8,645,173). The 
      analyses focus on: length of stay, Diagnosis Related Groups (DRG), Major 
      Diagnosis Categories (MDC), and effective Case Mix Index (CMI). RESULTS: The 
      length of stay in the IPD (M = 5.38 +/- 7.31) was significantly shorter than the 
      DRG defined length of stay (M = 5.8 +/- 4.71; p < .001; d = - 0.07) and did not 
      exceed or undercut the DRG covered length of stay. Compared to the entirety of 
      all pediatric departments (M = 4.74 +/- 6.23) the length of stay was significantly 
      longer in the in the IPD (p <. 001; d = 0.12). The effective CMI in IPD and all 
      pediatric departments were identical (M = 0.76). The frequencies of DRG and MDC 
      differed between IPD and all pediatric departments, with higher frequencies of 
      DRGs and MDCs associated with chronic and severe illnesses in the IPD. 
      CONCLUSIONS: Treatment within integrative anthroposophic pediatric departments 
      fits well in terms of the DRG defined conditions concerning length of stay, even 
      though integrative pediatric patients has an increased length of stay of 
      averagely 1 day, which is most likely associated to time consuming, complex 
      integrative treatment approaches and to a certain extend to higher amount of 
      chronic and severe diseases.
FAU - Fetz, Katharina
AU  - Fetz K
AUID- ORCID: 0000-0002-2391-2243
AD  - Department of Psychology, Chair of Research Methodology and Statistics in 
      Psychology, Witten/Herdecke University, Alfred-Herrhausen-Strasse 50, 58448, 
      Witten, Germany. Katharina.fetz@uni-wh.de.
FAU - Langler, Alfred
AU  - Langler A
AD  - Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 
      4, 58313, Herdecke, Germany.
AD  - Professorship for Integrative Pediatrics, Institute for Integrative Medicine, 
      Witten/Herdecke University, Alfred-Herrhausen-Strasse 50, 58448, Witten, Germany.
FAU - Schwermer, Melanie
AU  - Schwermer M
AD  - Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 
      4, 58313, Herdecke, Germany.
FAU - Carvalho-Hilje, Clara
AU  - Carvalho-Hilje C
AD  - Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 
      4, 58313, Herdecke, Germany.
AD  - Professorship for Integrative Pediatrics, Institute for Integrative Medicine, 
      Witten/Herdecke University, Alfred-Herrhausen-Strasse 50, 58448, Witten, Germany.
FAU - Vagedes, Jan
AU  - Vagedes J
AD  - ARCIM Academic Research in Complementary and Integrative Medicine, Filderstadt, 
      Germany.
AD  - Department of Neonatology, University Hospital Tuebingen, Calwerstrasse 7, 72076, 
      Tubingen, Germany.
FAU - Zuzak, Tycho Jan
AU  - Zuzak TJ
AD  - Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 
      4, 58313, Herdecke, Germany.
AD  - Department of Pediatric Oncology and Hematology, University Hospital Essen, 
      Hufelandstr.55, 45147, Essen, Germany.
FAU - Ostermann, Thomas
AU  - Ostermann T
AD  - Department of Psychology, Chair of Research Methodology and Statistics in 
      Psychology, Witten/Herdecke University, Alfred-Herrhausen-Strasse 50, 58448, 
      Witten, Germany.
LA  - eng
GR  - 150096/MAHLE foundation/
GR  - 335/Christophorus foundation/
PT  - Comparative Study
PT  - Journal Article
DEP - 20201012
PL  - England
TA  - BMC Health Serv Res
JT  - BMC health services research
JID - 101088677
SB  - IM
MH  - *Anthroposophy
MH  - Child
MH  - Germany
MH  - Health Resources/*statistics & numerical data
MH  - Hospital Departments/*statistics & numerical data
MH  - Humans
MH  - *Integrative Medicine
MH  - *Pediatrics
PMC - PMC7552368
OTO - NOTNLM
OT  - Anthroposophic medicine
OT  - Children
OT  - Cost analysis
OT  - DRG
OT  - Integrative medicine
OT  - MDC
OT  - Pediatrics
OT  - Resource utilization
COIS- The authors declare that they have no competing interests.
EDAT- 2020/10/14 06:00
MHDA- 2021/02/03 06:00
PMCR- 2020/10/12
CRDT- 2020/10/13 05:28
PHST- 2020/04/22 00:00 [received]
PHST- 2020/09/30 00:00 [accepted]
PHST- 2020/10/13 05:28 [entrez]
PHST- 2020/10/14 06:00 [pubmed]
PHST- 2021/02/03 06:00 [medline]
PHST- 2020/10/12 00:00 [pmc-release]
AID - 10.1186/s12913-020-05782-6 [pii]
AID - 5782 [pii]
AID - 10.1186/s12913-020-05782-6 [doi]
PST - epublish
SO  - BMC Health Serv Res. 2020 Oct 12;20(1):939. doi: 10.1186/s12913-020-05782-6.