Inpatient Treatment for Severe Nonsurgical Dermatological Disorders: Prevalence, Care Infrastructure and Reimbursement in Switzerland

Publikation

Inpatient Treatment for Severe Nonsurgical Dermatological Disorders: Prevalence, Care Infrastructure and Reimbursement in Switzerland

Wissenschaftlicher Artikel/Review - 19.08.2015

Mehra Tarun, Hoetzenecker Wolfram, Moos Rudolf, Volbracht Joerk, Guenova Emmanuella, French Lars E, Hafner Jürg

Zitation

Mehra T, Hoetzenecker W, Moos R, Volbracht J, Guenova E, French L, Hafner J. Inpatient Treatment for Severe Nonsurgical Dermatological Disorders: Prevalence, Care Infrastructure and Reimbursement in Switzerland. Dermatology (Basel) 2015; 231:260-8.

Art

Wissenschaftlicher Artikel/Review (Englisch)

Zeitschrift

Dermatology (Basel) 2015; 231

Veröffentlichungsdatum

19.08.2015

eISSN (Online)

1421-9832

Seiten

260-8

Kurzbeschreibung/Zielsetzung

BACKGROUND
Since 2012, Swiss inpatient dermatology is funded through a flat rate payment system based on diagnosis-related groups (DRGs).

OBJECTIVE
To analyze the reimbursement of nonsurgically treated severe disorders of the skin under the system called SwissDRG.

METHODS
Three retrospective, cross-sectional cohort studies were performed. Data sets were received from the Swiss Federal Office of Statistics (1,285,685 retained records), the five Swiss university hospitals (370,964 retained records) and our center (72,211 retained records).

RESULTS
Cases accounted for 0.04% of all hospitalizations nationwide, with 43.7% treated at university hospitals. Treatment at university hospitals produced a mean loss of USD 3,711 per case. Lyell syndrome cases were especially underfunded (mean loss USD 31,906). Extra-county admissions and direct referrals were significant predictors of total inpatient costs (p = 0.019 and p < 0.001, respectively).

CONCLUSIONS
We suggest grouping Lyell syndrome cases into burn DRGs and evaluating extra-county admissions and direct inpatient referrals as DRG split criteria.