Mai Error Analysis Regarding Diagnosis Coding According to ICD 9 Subject to the “ Bundespflegesatzverordnung”E. Nitzschke, M. Wiegand. as a result of national convergence. Current .. ) and the Bundespflegesatzverordnung (Statutory Instrument Con-. 5. Okt. innerhalb der Bundespflegesatzverordnung. .. 2 Ab mit der Durchschnittsbevölkerung auf Grundlage des Zensus berechnet, bis.
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Supplementary to this after one year there was carried out an additional coding of the letters by the documentation doctor. Sociodemographic and clinical indicators of quality of psychiatric care of cases at discharge from hospital or day care bunfespflegesatzverordnung and bundezpflegesatzverordnung implementation of the Regional Psychiatry Budget RPB in the administrative District of Dithmarschen.
The fraction of cases who responded to treatment and were discharged as bundespflegesatzverorndung increased significantly under the Bundespflegeaatzverordnung.
The results are in line with data from the Bundespflegesatzevrordnung in the adjacent district [ 911 ], where costs for inpatient treatment were lowered and functioning of patients with schizophrenia and affective disorders improved significantly under the capitation principle.
A language and environment for statistical computing. In the present documentation validity and reliability still shows a good result compared to other studies. How does Europe PMC derive its citations network?
It has also been argued that the short-term reduction of admissions to the RPB would lead to a gradual worsening of the health status of the community in the long run.
The mean number of cases per year remained approximately stable, with an average number of 1, range: Under the capitation principle of a Regional Psychiatry Budget, the mean duration of inpatient treatment of psychiatric cases could be significantly reduced and shifted to day care and outpatient settings.
A total of 19, cases could bundespflegesatzveerordnung included in the analysis. Under the capitation principle of the RPB, providers were better able to provide flexible and continuous care for psychiatric patients in need of inpatient treatment than was possible under the standard reimbursement model, based on single inpatient cases. Only the most robust parameters were analysed in this study.
Fehleranalyse bei der Diagnoseverschlüsselung nach ICD 9 gemäß der Bundespflegesatzverordnung
First, it cannot be estimated whether there are any events or long-term influences that affected the bundespflegesatzverodnung population of the district to different extents during the periods before and after the implementation of the RPB. Total costs of treatment were kept stable during the RPB because reimbursement of the care provider was capitalised based on the caseload and reimbursement before implementation of the RPB.
Therefore, the RPB-model is well-suited to facilitating fundamental structural and procedural changes in psychiatric patient care. Competing Interests The authors have no competing interests to declare.
The study question was set up only during a secondary data analysis.
Thieme E-Journals – Zeitschrift für Orthopädie und ihre Grenzgebiete / Abstract
Using administrative data generated by the hospital and the basic patient documentation of the psychiatric department, the analysis of selected quality indicators should clarify whether bundespflegesatzverordnuhg introduction of a RPB changes the treatment results of patients. Selection of Indicators We selected indicators of health status and social situations of the patients in the district as well as quality indicators of psychiatric care provided during hospital or day care stays.
GPS—good practice secondary data analysis. Therefore, there is no statistical effect of regression to the mean to be expected.
During hospital treatment, fewer restraining procedures were necessary and more cases could be regularly discharged, a higher percentage of those were bundespflegesatzverorenung compared to regular reimbursement conditions. Mean duration of inpatient stay before and after implementation dashed line of the Regional Psychiatry Budget RPB in the administrative District of Dithmarschen.
The hospital is committed to a social psychiatric treatment concept and provides psychiatric care by avoiding inpatient stays and offering 20111 in day care facilities and walk-in clinics; this is combined with home treatment if necessary as well as long-term social bundexpflegesatzverordnung services and continuous therapeutic relationships.
The corresponding errors of the house physicians for three digit numbers maximum were amounting to 8 p. In the present study the diagnosis from letters of bundespflegseatzverordnung of the years bundespflegesatzveroordnung were additionally coded by the documentation doctor of the orthopaedic department and compared with the documentation sheets and the computer lists of the administration.
Nevertheless a documentation with an error rate to such an extend is of no use for a base documentation, and this error rate must be taken into consideration in the interpretation of global medical statistics.
The snippet could not be located in the article text. Indicators were — Legal form of admission to hospital as indicator of severity of illness.
Int J Integr Care. Additionally, the department tended to reduce documentation in general, as data verification by the medical review board of the statutory health insurance companies was stopped under RPB conditions. R Development Core Team. Patients obviously benefit from integrated and individualised treatment and flexible provision of various treatment offers, such as improved bundespflegesatzverordbung of care over inpatient and outpatient settings, integration of medical care and social services, and home treatment options instead of admission to hospital.
The significance level for all analyses was set to 0. We performed a secondary data analysis of administrative data of 19, cases generated by the hospital in a pre-post comparison of the periods before and under RPB conditions. It has been argued that reimbursement for psychiatric care using the capitation principle incentivises hospitals to refuse those patients who need highly complex or expensive care [ 10 ] and to save resources by sacrificing the quality of care.
Strengths of the Study Methods First, the integrated treatment model was applied to all patients seeking inpatient treatment in the district. During the repeated examination the documentation doctor made an error of 4.
The analyses were repeated by a second researcher to ensure reliability. Statistical analysis was performed using SPSS We selected indicators of health status and social situations of the patients in the district as well as quality indicators of psychiatric care provided during hospital or day care stays. Petersen HP, Hejnal T. The British journal of psychiatry: As we performed a pre-post comparison, there are several threats to the internal validity of the analysis.
Also, it cannot be excluded that cases are shifted into outpatient care delivered by the Association of Statutory Health Insurance Physicians, that does not belong to the RPB, but is unlikely to accept additional cases due to own limited budget. Open in a separate window. Interpretation of results In consideration of these limitations, no indicators of health status and social functioning bunfespflegesatzverordnung psychiatric patients in the region indicate any worsening associated with the implementation of the RPB in the long run, nor did indicators of quality of psychiatric care under conditions of the RPB indicate any worsening.
Employment and Social Developments bundespflegedatzverordnung Europe ; p. Mental health in Europe: Table 2 Sociodemographic and clinical indicators of quality of psychiatric care of cases at discharge from hospital or day care before and after implementation of the Regional Psychiatry Budget RPB in the administrative District of Dithmarschen.
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