[Random sampling according to section 17 c KHG--report on the experience of maximal care hospitals in Hesse]. / Die Stichprobenprüfung nach 17 c KHG--Erfahrungsbericht aus Krankenhäusern der Maximalversorgung in Hessen.

ABSTRACT

Hospital billing converted to "German diagnosis-related groups" (G-DRG) for in-patient treatment in Germany is reviewed, except in psychiatry where per-diems are still in use. Currently thousands of bills are sent to the Medical Service for scrutiny. In addition, the law relating to Hospital Financing (Krankenhausfinanzierungsgesetz, para. 17 c) provides for systematic checks on a random sample of bills from a given hospital. The Medical Service of the Social Security Health Insurance reports on the experience in the State of Hessen. Present regulations exclude from the random sample those bills that have already been presented for a check on a case by case basis. Excluding these cases from the random sample introduces a bias in an avoidable way. The present rule is contrary to valid conclusions from the random sampling and should be abolished.