Comparative analysis of resource utilization in integrative anthroposophic and all German pediatric inpatient department
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RESEARCH ARTICLE
Open Access
Comparative analysis of resource utilization in integrative anthroposophic and all German pediatric inpatient departments Katharina Fetz1* , Alfred Längler2,3, Melanie Schwermer2, Clara Carvalho-Hilje2,3, Jan Vagedes4,5, Tycho Jan Zuzak2,6 and Thomas Ostermann1
Abstract 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 2499 g, without complex diagnosis; n = 1254, 4.2%), G67C (esophagitis, gastroenteritis, gastrointestinal bleeding, ulcer, uncomplex genesis; n = 1158, 3.9%) and P67B (n = 975, 3.3%, newborn > 2499 g, with complex diagnosis).
In the entirety of all pediatric departments, the most frequent DRG’s were G67B (esophagitis, gastroenteritis, gastrointestinal bleeding, ulcer, complex genesis; n = 561, 552; 8.78%) G67C (esophagitis, gastroenteritis, gastrointestinal bleeding, ulcer, uncomplex genesis; n = 440,529; 6.89%); B80Z (head injuries; n = 382,762; 5.99%) and D63Z (otitis media or infections of the upper respiratory tract, age < 3 years; n = 310,283; 4.85%). The 50 most frequent DRG in both groups per year and overall are shown in the supplemental materials 1 and 2. Major diagnosis categories
The most frequent MDC in the integrative sample were Diseases and Disorders of the Nervous System (n = 5366,
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Fig. 2 Mean length of stay in the integrative departments and all German pediatric departments compared to the DRG defined mean length of stay
Fetz et al. BMC Health Services Research
(2020) 20:939
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