Medizin unter Finanzierungsvorbehalt
Ausgabe: 1/2009
55. Jahrgang
Auswirkungen der DRG-Vergütung auf ärztliche Entscheidungen: Eine ethische Analyse
The introduction of a prospective payment system based on diagnosis related groups (DRGs) has had considerable effects on patient care in German hospitals. The financial resources are limited in such a way that the cost-pressure on the meso and micro levels increases. The consequences for the physicians decisions are ambivalent. On the one hand, physicians have an incentive to forego futile diagnostic and therapeutic interventions and shorten the patients length of stay. On the other hand, there is a real danger that physicians respond to the increasing scarcity of resources by withholding beneficial medical interventions, i. e. by rationing. The paper discusses how the effects on inpatient care can be evaluated from an ethical perspective, taking into account the results of available empirical studies. It concludes with some suggestions how physicians can perform the inevitable bedside rationing in an ethically appropriate manner.
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