[German Refined-Diagnosis Related Groups, version 2007. The depiction of intensive care medicine]

Abstract

Since the G-DRG system was introduced in Germany in 2004, attempts have been made to model medical services performed in the intensive care units on a performance-oriented system by capitation. Based on this background the InEK, the institution which is responsible for design and development of the G-DRG system, has implemented several new issues into the version for 2007 which will be presented in this article. On the one hand the changes concerning the coding rules of diagnosis and procedures will be described and on the other hand important topics, such as "multimodal intensive care" or "complex treatment of patients with severe infections by multi-resistant pathogens", will be focused on. Furthermore, some new developments concerning the global functions ("complex procedures", "complex intensive treatment") as well as the changes in the coding rule for the demographic factor "mechanical ventilation" will be discussed. Finally, the regulations for additional remuneration are updated. In general, the attempts of the InEK to improve the G-DRG mapping for intensive care medicine are welcome and constructive. The regulations provided seem to be beneficial, but at the same time complicating the instructions. Hence, standardisation of intensive care medicine via diagnosis-related-groups still remains inadequate and therefore unsatisfactory in 2007.