Rehabilitee-Management-Categories (RMK) - Results of the Development Phase and of the First Clinical Implementation in Alcohol Rehabilitation Centres].
Due to the introduction of lump sum reimbursement systems for acute-care settings (DRGs), patient classification systems have been developed in Germany during the last 15 years to adapt a case-based lump sum system to the field of medical rehabilitation. The concept of Rehabilitee-Management-Categor...
| Publicado en: | Rehabilitation Vol. 50; no. 5; pp. 298 - 308 |
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| Autores principales: | , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Georg Thieme Verlag Stuttgart
2011 Oct
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=108196422&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 108196422 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00343536 ILN jtl: Rehabilitation issn: 00343536 maglogo: N pubinfo: dt: 2011 Oct vid: 50 iid: 5 pid: 4536 pub: Georg Thieme Verlag Stuttgart artinfo: ui: 108196422 108196422 2011310876 10.1055/s-0031-1285918 NLM21976263 108196422 ppf: 298 ppct: 10 formats: tig: atl: Rehabilitee-Management-Categories (RMK) - Results of the Development Phase and of the First Clinical Implementation in Alcohol Rehabilitation Centres]. aug: au: Spyra K Köhn S Ammelburg N Schmidt C Missel P Lindenmeyer J sug: subj: Alcohol Rehabilitation Programs Case Management Economics National Health Programs Economics Rehabilitation Centers Economics Alcoholism Classification Alcoholism Economics Disability Evaluation Germany Health Resource Allocation Economics Health and Welfare Planning Economics Health Services Needs and Demand Economics Health Services Research Economics Human Patient Admission Economics Nursing Care Plans Economics Reimbursement Mechanisms Economics Economic and Social Security Economics ab: Due to the introduction of lump sum reimbursement systems for acute-care settings (DRGs), patient classification systems have been developed in Germany during the last 15 years to adapt a case-based lump sum system to the field of medical rehabilitation. The concept of Rehabilitee-Management-Categories (RMK), developed by the Charité - Universitätsmedizin Berlin, classifies rehabilitees primarily by their relevant impairments of activity and participation, as these factors mainly determine treatment needs and resources required in rehabilitation. It can, inter alia, be used to optimize the demand-related allocation of treatment services in the rehabilitation centres as well as lead to more transparency in the allocation process. RMK results are reported on the example of inpatient rehabilitation of alcohol dependence.Utilizing internationally established assessments, an RMK-assessment was developed that allows the assessment of rehab treatment needs of patients undergoing alcohol dependence rehabilitation. The RMK-assessment was completed by n=731 rehabilitees. Latent class analysis was applied to find groups of cases. To facilitate the RMK-patient classification a software-based algorithm was developed and implemented in 12 rehabilitation centres (implementation study). To validate the results of the first study phase, the data collected during implementation (n=1 533) was again analyzed using latent class analysis. Combined standardized and qualitative user surveys were conducted at the end of the implementation study.On the basis of 15 needs-related patient characteristics, 4 comparable case groups (AL-1 to AL-4) each were identified in 2 independent samples, groups that differed significantly in their degree of dependence-related, psychological and social impairment. The user survey confirmed the basic clinical plausibility of the 4 different case groups as well as the feasibility of the instruments applied in a rehabilitation setting.The RMK-concept offers a new approach for a demand-related patient classification in medical rehabilitation. The RMK-instruments allow a standardized initial assessment of impairment and treatment needs in alcohol rehabilitation and can hence be used for objective comparisons between rehabilitation centres. The results of the RMK-assessment provide relevant information about demand-related treatment requirements, which is a matter of great interest in the context of limited resources. Appropriate treatment requirements for the 4 RMK-case groups will be defined and verified in the next step of the RMK-concept. A financial evaluation of the RMK is possible in principal, will however require more extensive development, not least in order to model and evaluate the health-economic implications involved. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: German refInfo: holdings: @attributes: islocal: N |
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