Diagnosis-Related Groups in Hand Surgery – a comparison of six European countries [Fallpauschalen in der Handchirurgie – ein Vergleich von sechs europ ischen L ndern]

[english] Diagnosis-Related Group (DRG) is a classification system, which groups patients according to their diagnosis and resource consumption. Common hand surgical diagnoses and procedures were processed using national DRG-groupers of six European countries. The upper thresholds of length of stay (LoS) are indicated for every country with the exception of Spain. The mean value in the series was 9.9 days for Germany, 4.5 days for Austria, 10.7 days for Italy, 9.7 days for Sweden and 9.4 days for the United Kingdom (UK). Germany and Austria also have lower thresholds of LoS and the average LoS.Multiple finger replantation presented the highest single case reimbursement in Germany, Austria and the UK (13,825 €, 10,576 € and Scaphoid non-union had the highest single case reimbursement in Italy (2,676 €), flap coverage of wounds in Spain (5,506 €) and trapeziometacarpal arthritis in Sweden (5,350 €). The mean values for single case reimbursement were as follows: Germany 3,211 €, Austria 2,821 €, Italy 1,947 €, Spain 3,594 €, Sweden 2,403 € and the UK 3,253 €. Ten out of 19 cases showed the highest reimbursement in Spain, followed by the UK (5 cases), Sweden (2 cases), Germany and Austria (1 case each). Applying the case numbers of our clinic to the reimbursement system of each country, total proceeds would be 2.25 million € in Spain, in Germany as well as the UK, 1.75 million € in Austria, in Sweden and 1.22 million € in Italy. The consequences of international differences in efficiency and reimbursement are hard to assess as they are influenced by multiple factors that are seldom purely market-driven. However, the consideration of international data for benchmarking and refinement of national compensation systems should be a useful instrument. [german] Diagnosis-Related Groups (DRG) bezeichnet ein Klassifikationssystem, welches Patienten anhand ihrer Diagnosen und des Ressourcenverbrauchs einteilt. H ufige handchirurgische Diagnosen und Prozeduren wurden mit den nationalen DRG-Groupern sechs europ ischer L nder bearbeitet.Die obere Grenzverweildauer (oGVD) wurde au er für Spanien in allen L ndern angegeben. Die mittlere oGVD lag bei 9,9 Tagen für Deutschland, 4,5 Tagen für sterreich, 10,7 Tagen für Italien, 9,7 Tagen für Schweden und 9,4 Tagen für Gro britannien (UK). Nur für Deutschland und sterreich standen die untere Grenzverweildauer und die mittlere Verweildauer zur Verfügung.Mehrfingerreplantationen zeigten die h chste Einzelfallvergütung in Deutschland, sterreich und UK (13.825 €, 10.576 € und 9.198 €). Kahnbeinpseudarthrosen erzielten die h chst