Ensuring Quality in Interdisciplinary Inpatient Chronic Care

Abstract

Pay for Quality (P4Q) concepts are discussed as solution for ensuring quality in health care in the context of budgetary concerns. However, little is known regarding the application to and effectiveness for complex chronic treatments. This article describes the incentivization approach taken in Germany, where complex codes requiring specific quality criteria were implemented into the Diagnosis Related Groups (DRGs) system. Using two examples (early complex geriatric rehabilitation, multimodal rheumatological complex treatment), we analyze the quality indicators according to the Donabedian Model and contrast the effects regarding compensation to traditional treatments. In total, the approach allows taking into account treatment and financial requirements.