The Pkms (German Score For Complex Nursing Measures) As Paradigm Shift In The G-Drg System: A Retrospective Observational Study Based On Billing Data

Aims The introduction of the Complex Care Measures Score (German: Pflegekomplexma ss nahmen-Score, PKMS) is widely considered a paradigm shift in the G-DRG system. The aim of this study was to analyze the incentive structure emerging in the G-DRG system as a result of the PKMS.Methods To this end, all PKMS cases treated at the University Medical Centre Freiburg in 2014 were analyzed in a retrospective observational study.Results The average Mean Duration of Hospitalization (Mittlere Verweildauer, MVD) of the billed DRGs was significantly exceeded by the PKMS patients (by 16.5 days and 77.8 %, p < 0.001). The additional reimbursements set by the PKMS system do not even come close to compensating for the additional length of stay assuming standard daily hospital cost.Conclusion Although some manner of compensatory effect cannot be ruled out it has to be assumed that the additional reimbursements are simply too low to have an effect on the incentives to lower length of stay built into the G-DRG system.