Costs of stroke unit care in Germany. Resource use and reimbursements by German diagnosis-related groups [Kosten der stroke-unit-care in Deutschland. Ressourcenverbrauch und erlöse mit deutschen diagnosis related groups]

Background. Stroke care has a high impact on health costs. Therefore, the costs and reimbursements of integrated stroke care were calculated in a German neurological university hospital. Patients and methods. Patient cohorts of 2002 and 2003 were considered. All patients were included who presented with ischemic stroke, intracerebral hemorrhage, or transient ischemic attacks. G-DRG reimbursements were calculated by using the 3M grouper versions 2.2.0 for 2003 and 3.1 for 2004. Results. There were no significant differences between the two patient cohorts. Compared to the former reimbursement system based on fixed daily charges, a base rate of EUR 3,204 was required for a neutral budget in 2002. The actual base rate was EUR 3,169. Assuming this base rate, an average reimbursement of EUR 4,201 (grouper 2.2.0) and of EUR 3,657 (grouper 3.1) was achieved per patient in 2002. An average reimbursement of EUR 4,107 (grouper 2.2.0) and of EUR 3,351 (grouper 3.1) was achieved per patient in 2003. Conclusion. The development of reimbursements by the G-DRGs shows a clear downward trend and shows that the high resource use in stroke unit care is inadequately reflected by the G-DRGs.