German DRG system 2009. The perspectives for vascular surgery

Background. The German DRG (G-DRG) system was also further developed into version 2009 and changes concerning coding of diagnoses, medical procedures and the DRG structure were made which have a significant effect on vascular surgery. Methods. An analysis of the changes in relevant diagnoses, medical procedures and G-DRGs between the versions 2008 and 2009 was carried out based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Results. Changes for 2009 focussed on the development of DRG structure, DRG validation and codes for medical procedures to be used for very complex cases. The outcome of these changes for German hospitals may vary depending on the range of activities of individual clinics. Conclusion. The restructuring of the G-DRG system for 2009 has led to another increase in complexity. High demands are made on correct and complete coding of complex vascular surgery cases. Quality of case allocation within the G-DRG system was improved. Despite many improvements further adjustments for the future of the G-DRG system are necessary, especially for cases with bilateral surgery and therapy of multiple drug-resistant infections.