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Comparative analysis of resource utilization in integrative anthroposophic and all German pediatric inpatient departments

BACKGROUND: Integrative Medicine (IM) combines conventional and complementary therapies. It aims to address biological, psychological, social, spiritual and environmental aspects of patients’ health. During the past 20 years, the use and request of IM in children and adults has grown. Anthroposophic...

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Autores principales: Fetz, Katharina, Längler, Alfred, Schwermer, Melanie, Carvalho-Hilje, Clara, Vagedes, Jan, Zuzak, Tycho Jan, Ostermann, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7552368/
https://www.ncbi.nlm.nih.gov/pubmed/33046108
http://dx.doi.org/10.1186/s12913-020-05782-6
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author Fetz, Katharina
Längler, Alfred
Schwermer, Melanie
Carvalho-Hilje, Clara
Vagedes, Jan
Zuzak, Tycho Jan
Ostermann, Thomas
author_facet Fetz, Katharina
Längler, Alfred
Schwermer, Melanie
Carvalho-Hilje, Clara
Vagedes, Jan
Zuzak, Tycho Jan
Ostermann, Thomas
author_sort Fetz, Katharina
collection PubMed
description BACKGROUND: Integrative Medicine (IM) combines conventional and complementary therapies. It aims to address biological, psychological, social, spiritual and environmental aspects of patients’ health. During the past 20 years, the use and request of IM in children and adults has grown. Anthroposophic Medicine (AM) is an IM approach frequently used in children in Germany. From both public health and health economic perspectives, it is relevant to investigate whether there are differences in the resource utilization between integrative pediatric departments (IPD) and the entirety of all pediatric departments. METHODS: Standard ward documentation data from all German integrative anthroposophic pediatric departments (2005–2016; N = 29,956) is investigated and systematically compared to data of the entirety of all pediatric departments in Germany derived from the Institute for the Hospital Reimbursement System (2005–2016, N = 8,645,173). The analyses focus on: length of stay, Diagnosis Related Groups (DRG), Major Diagnosis Categories (MDC), and effective Case Mix Index (CMI). RESULTS: The length of stay in the IPD (M = 5.38 ± 7.31) was significantly shorter than the DRG defined length of stay (M = 5.8 ± 4.71; p < .001; d = − 0.07) and did not exceed or undercut the DRG covered length of stay. Compared to the entirety of all pediatric departments (M = 4.74 ± 6.23) the length of stay was significantly longer in the in the IPD (p <. 001; d = 0.12). The effective CMI in IPD and all pediatric departments were identical (M = 0.76). The frequencies of DRG and MDC differed between IPD and all pediatric departments, with higher frequencies of DRGs and MDCs associated with chronic and severe illnesses in the IPD. CONCLUSIONS: Treatment within integrative anthroposophic pediatric departments fits well in terms of the DRG defined conditions concerning length of stay, even though integrative pediatric patients has an increased length of stay of averagely 1 day, which is most likely associated to time consuming, complex integrative treatment approaches and to a certain extend to higher amount of chronic and severe diseases.
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spelling pubmed-75523682020-10-13 Comparative analysis of resource utilization in integrative anthroposophic and all German pediatric inpatient departments Fetz, Katharina Längler, Alfred Schwermer, Melanie Carvalho-Hilje, Clara Vagedes, Jan Zuzak, Tycho Jan Ostermann, Thomas BMC Health Serv Res Research Article BACKGROUND: Integrative Medicine (IM) combines conventional and complementary therapies. It aims to address biological, psychological, social, spiritual and environmental aspects of patients’ health. During the past 20 years, the use and request of IM in children and adults has grown. Anthroposophic Medicine (AM) is an IM approach frequently used in children in Germany. From both public health and health economic perspectives, it is relevant to investigate whether there are differences in the resource utilization between integrative pediatric departments (IPD) and the entirety of all pediatric departments. METHODS: Standard ward documentation data from all German integrative anthroposophic pediatric departments (2005–2016; N = 29,956) is investigated and systematically compared to data of the entirety of all pediatric departments in Germany derived from the Institute for the Hospital Reimbursement System (2005–2016, N = 8,645,173). The analyses focus on: length of stay, Diagnosis Related Groups (DRG), Major Diagnosis Categories (MDC), and effective Case Mix Index (CMI). RESULTS: The length of stay in the IPD (M = 5.38 ± 7.31) was significantly shorter than the DRG defined length of stay (M = 5.8 ± 4.71; p < .001; d = − 0.07) and did not exceed or undercut the DRG covered length of stay. Compared to the entirety of all pediatric departments (M = 4.74 ± 6.23) the length of stay was significantly longer in the in the IPD (p <. 001; d = 0.12). The effective CMI in IPD and all pediatric departments were identical (M = 0.76). The frequencies of DRG and MDC differed between IPD and all pediatric departments, with higher frequencies of DRGs and MDCs associated with chronic and severe illnesses in the IPD. CONCLUSIONS: Treatment within integrative anthroposophic pediatric departments fits well in terms of the DRG defined conditions concerning length of stay, even though integrative pediatric patients has an increased length of stay of averagely 1 day, which is most likely associated to time consuming, complex integrative treatment approaches and to a certain extend to higher amount of chronic and severe diseases. BioMed Central 2020-10-12 /pmc/articles/PMC7552368/ /pubmed/33046108 http://dx.doi.org/10.1186/s12913-020-05782-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Fetz, Katharina
Längler, Alfred
Schwermer, Melanie
Carvalho-Hilje, Clara
Vagedes, Jan
Zuzak, Tycho Jan
Ostermann, Thomas
Comparative analysis of resource utilization in integrative anthroposophic and all German pediatric inpatient departments
title Comparative analysis of resource utilization in integrative anthroposophic and all German pediatric inpatient departments
title_full Comparative analysis of resource utilization in integrative anthroposophic and all German pediatric inpatient departments
title_fullStr Comparative analysis of resource utilization in integrative anthroposophic and all German pediatric inpatient departments
title_full_unstemmed Comparative analysis of resource utilization in integrative anthroposophic and all German pediatric inpatient departments
title_short Comparative analysis of resource utilization in integrative anthroposophic and all German pediatric inpatient departments
title_sort comparative analysis of resource utilization in integrative anthroposophic and all german pediatric inpatient departments
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7552368/
https://www.ncbi.nlm.nih.gov/pubmed/33046108
http://dx.doi.org/10.1186/s12913-020-05782-6
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