Reimbursement for hospitalacquired infections with multidrug resistant organisms in German DRG system

Abstract

Hospital-acquired infections (HAIs), especially caused by multidrug resistant organisms (MDROs) are one of significant cost drivers for healthcare systems worldwide, associated, inter alia, with additional costs for hospitals. An empirical study was conducted to analyse whether changes in German DRG system led to a better coverage of increased expenditure due to HAIs and the related prevention procedures. 784 patient records from six hospitals in Northeast Germany, documentation sheets as well as routine medical controlling data (including age, sex, length of stay, main diagnosis, secondary diagnoses, OPS-codes, DRG, effective cost weight) have been analysed. Study population showed overall an increased length of stay but higher in the MDRO-positive group. Average cost weight was increased by 1.74, average effective cost weight by 2.13. However, MDRO-patients gather lower revenue per day on average. The study demonstrated that MDRO-parameters are not fully incorporated in the applied DRG-coding procedures and hygiene expenditures are still underfunded.