RESUMO
According to the "Protection against Infection Act", public health services are obliged to supervise and consult the hygienic conditions not only in hospitals but also in ambulatory medical practices in Germany. Firstly, in this paper basic principles on transmission routes of pathogenic germs and general remarks on the infection control visits as well as on the special regulations (i.e., German commission on hospital hygiene and infection prevention) are described. Secondly, crucial points to be considered in all medical practices are mentioned. Finally, special issues in different practices are reported, such as dermatology, gastroenterology, gynaecology, paediatrics etc. This article aims to support the public health departments in their task to prevent infections in patients and personnel in medical practices.·
Assuntos
Assistência Ambulatorial/legislação & jurisprudência , Comissão Para Atividades Profissionais e Hospitalares/legislação & jurisprudência , Política de Saúde/legislação & jurisprudência , Higiene/legislação & jurisprudência , Controle de Infecções/legislação & jurisprudência , Saúde Pública/legislação & jurisprudência , Alemanha , HumanosAssuntos
Comissão Para Atividades Profissionais e Hospitalares/legislação & jurisprudência , Medicaid/legislação & jurisprudência , Medicare/legislação & jurisprudência , Qualidade da Assistência à Saúde/legislação & jurisprudência , Cicatrização , Ferimentos e Lesões , Comissão Para Atividades Profissionais e Hospitalares/normas , Humanos , Medicaid/normas , Medicare/normas , Qualidade da Assistência à Saúde/normas , Estados UnidosRESUMO
BACKGROUND: The German DRG (diagnosis-related groups) system has changed since the inauguration in 2005, whereby written inquiries and on-site auditing have been carried out by the medical inspection service for health insurance companies (MDK). Modifications in the G-DRG system are reflected in changes in the MDK visitations. This article describes exactly how these examinations have changed over time. In order to achieve this all auditing reports were evaluated. RESULTS: In the beginning correct coding and documentation were the most interesting items for the health insurance fund inspectors. Nowadays, length of in-patient treatment and specific points relating to current changes in the G-DRG system are being questioned. All areas of the hospital have now been examined during this period. There was no change in the loss resulting from the regular examinations over the years. However, the effort and input of manpower are extremely high. CONCLUSIONS: To cope with the changes in the German DRG system hospitals have to be flexible. The experiences with the regular MDK visitations can positively influence hospital organizational structures.