DRG payment system in Germany
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German clinics are very popular not only among the Russians, but also worldwide. Planning to undergo hospital treatment in Germany, of course, patients are wondering what is the cost of treatment and payment.
Consider the mechanism of formation of the cost of medical services in a hospital in German hospitals.

Since 2004, all public hospitals in Germany a unified system of calculating the cost of treatment on the basis of similarity of diagnoses called DRG (Diagnosis Related Groups - diagnostically related groups).

Under this system inpatient care paid by lump-sum rate for each case of treatment. This rate is calculated based on the diagnostic group, in which the patient is determined by the supplied primary diagnosis (eg, a disease of the nervous system, eye, ENT, respiratory, digestive, genital itd.) Further subdivision is performed on the basis of diagnoses and related complications (if they occur) as well as medical procedures (surgical or conservative treatment). By other criteria applicable to the classification are the floor and the patient's age, weight (for newborns), duration of mechanical ventilation (in hours), the reason for discharge and length of hospital stay.
 
Lump-sum rate for inpatient operates within a certain period of stay in hospital. There is a lower limit of this period, when the fare is deducted from the lump sum corresponding amount, as well as the upper bound, when a lump-sum rate adds an additional amount.

For example, if in a particular case the system is installed hospital stay duration from 4 to 20 days, during which time we apply a flat-rate tariff. If the patient stays in the hospital only 2 or 3 days, the lump sum is subtracted from a certain percentage for each unused day. In the case of extended stay longer than 20 days, the lump sum is calculated over a fixed percentage for each additional day of stay.

In every state in Germany for all public hospitals valid single base rate cost of hospital treatment for each case.

To calculate the final cost of treatment base rate is multiplied by a predetermined factor cost medical services rendered. This ratio helps to determine how the actual cost of treatment for an individual case above or below the base rate.

So, for example, "replacement pacemaker" is less complex than the "operation on the spleen." And if the first procedure with the established coefficient 1.017 is close in value to the base rate, the second procedure will cost twice as much. If we compare the "pacemaker replacement" and "minimal surgery on the knee, the patient's age <16", then the latter will cost about 75% of the first, which means that its coefficient is 0.75.
Lump sum for each case of inpatient treatment could be determined, as a rule, after the patient is discharged as on admission is impossible to say in advance, for example, what will be the duration of treatment, which will be carried out the operation, if there will be complications i.t . etc.

According to German law, the cost of hospital treatment in public hospitals is calculated by the DRG system for patients who use the services of national health insurance, and private patients, including for foreign patients came for treatment in Germany.

Along with the lump-sum rate for inpatient treatment, there are also various bonuses for a number of additional services that can be provided to the patient at his request. These include, for example, the treatment of the chief doctor or providing single chamber. The cost of these additional costs of treatment is determined individually for each patient and may vary in some clinic.

Principle of the DRG: «pay the same money for the same services." Its purpose is to stimulate competition between clinics and maximum transparency in the calculation of the costs of hospital treatment.

The basic rate of cost of hospital treatment uniform throughout Germany.
      
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