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Auswirkungen der DRGs auf die Arbeitsbedingungen, das berufliche Selbstverständnis und die Versorgungsqualität aus Sicht hessischer Krankenhausärzte

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  • Klinke, Sebastian
  • Müller, Rolf
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    Abstract

    Das Forschungsprojekt WAMP (Wandel von Medizin und Pflege im DRG-System) beschäftigt sich schon seit der Zeit vor der Einführung der Diagnosis Related Groups (DRGs) mit den (möglichen) Folgen der DRGs auf die Arbeitsbedingungen und die Versorgungsqualität im Krankenhaus. Die Grundannahme ist, dass die DRGs neben anderen ordnungspolitischen Faktoren dazu beitragen, die Strukturen im Krankenhaus zu verändern. Veränderte Strukturen im Krankenhaus haben wiederum Auswirkungen auf die Arbeitsorganisation, auf die Arbeitsprozesse, die Arbeitsbelastungen und somit indirekt auch auf die Versorgungsqualität. Die vorliegende Studie zeigt aus Sicht hessischer Krankenhausärzte den Wandel der Strukturen im Krankenhaus als auch der Arbeitsbedingungen, des beruflichen Selbstbildes und der Versorgungsqualität. Aus zwei in weiten Teilen identischen Befragungen Anfang 2004 und Ende 2005 lassen sich erste Tendenzen erkennen. In Bezug auf die Arbeitsbedingungen, das berufliche Selbstbild und die Versorgungsqualität besteht ein direkter Zusammenhang mit einer Ressourcenverknappung, die durch anhaltende Budgetierung und das neue Entgeltsystem ausgelöst wurde. -- Since the time before the implementation of the diagnosis related groups (DRGs) the research project WAMP (Changes in medicine and nursing in the DRG-system) deals with the consequences of the DRGs on working conditions and the quality of care in hospital. The project starts with the assumption, that the DRGs effects the structures in hospital care. Changes in these structures will cause changes in process organisation, working load and finally mediately on the quality of care. Based on two nearly identical investigation this study shows from the point of view of Hessian physicians the changes in process organisation, self definition and quality of care. The investigations where carried out in February 2004 and November 2005. First results show a coherence between the restricted budget and the DRGs on the one hand and the process organisation, self definition and the quality of care on the other hand.

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    Bibliographic Info

    Paper provided by University of Bremen, Centre for Social Policy Research (ZeS) in its series Working papers of the ZeS with number 04/2008.

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    Date of creation: 2008
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    Handle: RePEc:zbw:zeswps:042008

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    1. Leister, Jan Eric & Stausberg, Jurgen, 2005. "Comparison of cost accounting methods from different DRG systems and their effect on health care quality," Health Policy, Elsevier, vol. 74(1), pages 46-55, September.
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