Does the German DRG system influence the decision making process in vascular medicine?

During its learning phase, the German DRG system has become more and more complex. This also reflects more and more the everyday reality in hospitals. Detailed data leads to utter transparency in terms of the cost-profit ratio. Extremely expensive patients cannot be covered by the DRG system. This problem must be solved urgently. The vascular surgical DRG catalogue has been substantially diversified. By following the rules, costs should, in general, be covered quite adequately. Of special concern are the rules for case connection, duration of hospital stay and adequate coding. Efficient hospital management is crucial in order to obtain optimum profit with reasonable manpower. For the future, ending fixed budgets and the division between out and in patients are discussed.