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Book ; Online: G-IQI - German Inpatient Quality Indicators Version 5.4

Nimptsch, Ulrike / Mansky, Thomas

Bundesreferenzwerte für das Auswertungsjahr 2020

(Working papers in health services research)

2022

Series title	Working papers in health services research
Keywords	Quality Assurance (QA) & Total Quality Management (TQM) ; quality management; quality measurement; hospital; German DRG statistics
Language	German
Size	1 electronic resource (538 pages)
Publisher	Universitätsverlag der Technischen Universität Berlin
Publishing place	Berlin
Document type	Book ; Online
Note	German
HBZ-ID	HT030379239
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Book ; Online: G-IQI - German Inpatient Indicators Version 5.3 : Bundesreferenzwerte für das Auswertungsjahr 2019

Nimptsch, Ulrike / Mansky, Thomas

2021

Keywords	G-IQI ; quality measurement ; quality management ; hospital ; German DRG statistics
Size	1 electronic resource (493 pages)
Publishing place	Berlin
Document type	Book ; Online
Note	German ; Open Access
HBZ-ID	HT021233296
ISBN	9783798332409 ; 3798332401
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Book ; Online: Internationale Datengrundlagen für die Versorgungsforschung

Panteli, Dimitra / Röttger, Julia / Nimptsch, Ulrike / Busse, Reinhard

Impulse für Deutschland

(Working papers in health policy and management)

2022

Series title	Working papers in health policy and management
Keywords	Medicine ; data linkage; health services research; cross-country learning; data policy; health systems
Language	0\|d
Size	1 electronic resource (161 pages)
Publisher	Universitätsverlag der Technischen Universität Berlin
Publishing place	Berlin
Document type	Book ; Online
Note	German ; Open Access
HBZ-ID	HT021618299
ISBN	9783798332171 ; 3798332177
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article ; Online: Evaluating the consequences of health policy decisions.

Nimptsch, Ulrike

Israel journal of health policy research

2020 Volume 9, Issue 1, Page(s) 19

Abstract: Uncertainty about intended and possible unintended side effects makes it important to evaluate changes following health policy decisions. A recent IJHPR article by Greenberg et al. evaluated changes in emergency department care following a directive of ... ...

Abstract	Uncertainty about intended and possible unintended side effects makes it important to evaluate changes following health policy decisions. A recent IJHPR article by Greenberg et al. evaluated changes in emergency department care following a directive of the Israeli Ministry of Health to limit occupancy in internal medicine wards. Over a six-year observation period, they found that one-month mortality and one-week readmissions after ED visits remained unchanged, while increases in average ED visit length, as well as increased delay time from ED admission to ward were observed. These findings help to assess the impact of the occupancy limit directive and may support future health policy decisions.However, the study by Greenberg et al. was limited by the unavailability of diagnostic data, and this illustrates a significant issue that transcends this particular study. In many countries, policy-relevant administrative data are not sufficiently available on a timely basis. Data availability is the prerequisite for monitoring developments in patterns of care following health policy changes. Besides conducting retrospective studies, timely availability of data makes it possible to establish monitoring systems which may help decision makers assess the impact of policy changes, identify undesired developments early, and recognize changes in need or demand of health services within the population.
MeSH term(s)	Emergency Service, Hospital ; Health Policy ; Hospitalization ; Humans ; Israel ; Patient Readmission ; Retrospective Studies
Keywords	covid19
Language	English
Publishing date	2020-04-30
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	2657655-7
ISSN	2045-4015 ; 2045-4015
ISSN (online)	2045-4015
ISSN	2045-4015
DOI	10.1186/s13584-020-00380-7
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Evaluating the consequences of health policy decisions

Ulrike Nimptsch

Israel Journal of Health Policy Research, Vol 9, Iss 1, Pp 1-

2020 Volume 2

Abstract: Abstract Uncertainty about intended and possible unintended side effects makes it important to evaluate changes following health policy decisions. A recent IJHPR article by Greenberg et al. evaluated changes in emergency department care following a ... ...

Abstract	Abstract Uncertainty about intended and possible unintended side effects makes it important to evaluate changes following health policy decisions. A recent IJHPR article by Greenberg et al. evaluated changes in emergency department care following a directive of the Israeli Ministry of Health to limit occupancy in internal medicine wards. Over a six-year observation period, they found that one-month mortality and one-week readmissions after ED visits remained unchanged, while increases in average ED visit length, as well as increased delay time from ED admission to ward were observed. These findings help to assess the impact of the occupancy limit directive and may support future health policy decisions. However, the study by Greenberg et al. was limited by the unavailability of diagnostic data, and this illustrates a significant issue that transcends this particular study. In many countries, policy-relevant administrative data are not sufficiently available on a timely basis. Data availability is the prerequisite for monitoring developments in patterns of care following health policy changes. Besides conducting retrospective studies, timely availability of data makes it possible to establish monitoring systems which may help decision makers assess the impact of policy changes, identify undesired developments early, and recognize changes in need or demand of health services within the population.
Keywords	Medicine (General) ; R5-920 ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2020-04-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Treatment of Anorectal Malformations in German Hospitals: Analysis of National Hospital Discharge Data from 2016 to 2021.

Wilms, Miriam / Jenetzky, Ekkehart / Märzheuser, Stefanie / Busse, Reinhard / Nimptsch, Ulrike

European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie

2024

Abstract: Background: Anorectal malformations (ARMs) are complex congenital anomalies. The corrective operation is demanding and schedulable. Based on complete national data, patterns of care have not been analyzed in Germany yet.: Methods: All cases with ... ...

Abstract	Background: Anorectal malformations (ARMs) are complex congenital anomalies. The corrective operation is demanding and schedulable. Based on complete national data, patterns of care have not been analyzed in Germany yet. Methods: All cases with ARM were analyzed (1) at the time of birth and (2) during the hospital stay for the corrective operation, based on the national hospital discharge data (DRG statistics). Patient's comorbidities, treatment characteristics, hospital structures, and the outcome of corrective operations were analyzed with respect to the hospitals' caseload. Results: From 2016 to 2021, 1,726 newborns with ARM were treated at the time of birth in 388 hospitals. Of these hospitals, 19% had neither a pediatric nor a pediatric surgical department. At least one additional congenital anomaly was present in 49% of cases and 7% of the newborns had a birthweight below 1,500 g.In all, 2,060 corrective operations for ARM were performed in 113 hospitals in the same time period. In 24.5% of cases, at least one major complication was documented. One-third of the operations were performed in 56 hospitals, one-third in 20 hospitals, and one-third in 10 hospitals with median annual case numbers of 2, 5, and 10, respectively.Hospitals with the highest caseload operated cloacal defects more often than hospitals with the lowest caseload (7 vs. 2%) and had more early complications than hospitals with the lowest caseload (30 vs. 21%). This difference was not statistically significant after risk adjustment. Conclusions: Children with ARM are multimorbid. Early complications after corrective surgery are common. Considering the large number of hospitals with a very low caseload, centralization of care for the complex and elective corrective surgery for ARM remains a key issue for quality of care.
Language	English
Publishing date	2024-02-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	1065043-x
ISSN	1439-359X ; 0939-7248 ; 0939-6764 ; 0930-7249
ISSN (online)	1439-359X
ISSN	0939-7248 ; 0939-6764 ; 0930-7249
DOI	10.1055/a-2260-5124
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Article ; Online: How did the COVID-19 pandemic affect inpatient care for children in Germany? An exploratory analysis based on national hospital discharge data.

Panteli, Dimitra / Mauer, Nicole / Tille, Florian / Nimptsch, Ulrike

BMC health services research

2023 Volume 23, Issue 1, Page(s) 938

Abstract: Background: The delivery of health services around the world faced considerable disruptions during the COVID-19 pandemic. While this has been discussed for a number of conditions in the adult population, related patterns have been studied less for ... ...

Abstract	Background: The delivery of health services around the world faced considerable disruptions during the COVID-19 pandemic. While this has been discussed for a number of conditions in the adult population, related patterns have been studied less for children. In light of the detrimental effects of the pandemic, particularly for children and young people under the age of 18, it is pivotal to explore this issue further. Methods: Based on complete national hospital discharge data available via the German National Institute for the Reimbursement of Hospitals (InEK) data browser, we compare the top 30 diagnoses for which children were hospitalised in 2019, 2020, 2021 and 2022. We analyse the development of monthly admissions between January 2019 and December 2022 for three tracers of variable time-sensitivity: acute lymphoblastic leukaemia (ALL), appendicitis/appendectomy and tonsillectomy/adenoidectomy. Results: Compared to 2019, total admissions were approximately 20% lower in 2020 and 2021, and 13% lower in 2022. The composition of the most frequent principal diagnoses remained similar across years, although changes in rank were observed. Decreases were observed in 2020 for respiratory and gastrointestinal infections, with cases increasing again in 2021. The number of ALL admissions showed an upward trend and a periodicity prima vista unrelated to pandemic factors. Appendicitis admissions decreased by about 9% in 2020 and a further 8% in 2021 and 4% in 2022, while tonsillectomies/adenoidectomies decreased by more than 40% in 2020 and a further 32% in 2021 before increasing in 2022; for these tracers, monthly changes are in line with pandemic waves. Conclusions: Hospital care for critical and urgent conditions among patients under the age of 18 was largely upheld in Germany during the COVID-19 pandemic, potentially at the expense of elective treatments. There is an alignment between observed variations in hospitalisations and pandemic mitigation measures, possibly also reflecting changes in demand. This study highlights the need for comprehensive, intersectoral data that would be necessary to better understand changing demand, unmet need/foregone care and shifts from inpatient to outpatient care, as well as their link to patient outcomes and health care efficiency.
MeSH term(s)	Adult ; Humans ; Child ; Adolescent ; COVID-19/epidemiology ; Pandemics ; Appendicitis/epidemiology ; Appendicitis/surgery ; Inpatients ; Patient Discharge ; Hospitalization ; Hospitals ; Germany/epidemiology
Language	English
Publishing date	2023-08-31
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-023-09929-z
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Article ; Online: Inaccuracies.

Nimptsch, Ulrike / Krautz, Christian

Deutsches Arzteblatt international

2020 Volume 117, Issue 20, Page(s) 362–363

MeSH term(s)	Absorptiometry, Photon ; Digestive System Surgical Procedures
Language	English
Publishing date	2020-07-13
Publishing country	Germany
Document type	Letter ; Comment
ZDB-ID	2406159-1
ISSN	1866-0452 ; 1866-0452
ISSN (online)	1866-0452
ISSN	1866-0452
DOI	10.3238/arztebl.2020.0362b
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Article ; Online: Analyse der Zeitangaben in Krankenhausabrechnungsdaten bei ST-Streckenhebungs-Herzinfarkt und Linksherzkatheterintervention.

Nimptsch, Ulrike / Busse, Reinhard

Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany))

2021 Volume 83, Issue S 02, Page(s) S122–S129

Abstract: Background: German hospital administrative data contain demographic, medical, and administrative information on inpatients, as well as time stamps, such as time of admission or when a medical procedure was carried out. Time stamps allow the calculation ... ...

Title translation	ST-elevation Myocardial Infarction and Percutaneous Coronary Intervention: Analysis of Time Stamps in Hospital Administrative Data.
Abstract	Background: German hospital administrative data contain demographic, medical, and administrative information on inpatients, as well as time stamps, such as time of admission or when a medical procedure was carried out. Time stamps allow the calculation of important process indicators which may help to assess quality of care. However, regarding the plausibility of time stamps in German hospital administrative data, no information is as yet available. This study investigates time stamps through the example of ST-elevation myocardial infarction and percutaneous coronary intervention aiming to provide first indications on the plausibility of time stamp documentation. Methods: Based on complete national German hospital administrative data (DRG statistics) from 2014 to 2017, all inpatient cases with ST-elevation myocardial infarction in the first admitting hospital were identified. Date and time of admission and date and time of percutaneous coronary intervention were analyzed. Time intervals were calculated as difference between time of admission and time of percutaneous coronary intervention and were categorized in groups. Results: The analysis of time of admission of inpatient cases with ST-elevation myocardial infarction (n=254,719) showed a pattern with highest frequencies between 9 a.m. and 1 p.m. on working days. The pattern of time of percutaneous coronary interventions (n=206,079) was similar but revealed frequency peaks at noon and midnight. The share of inpatient cases with implausible time intervals between time of admission and time of percutaneous coronary intervention declined from 9.5% in 2014 to 7.8% in 2017 and showed high variation on the hospital level. Conclusion: Analyzing time stamps in hospital administrative data may provide valuable information on treatment processes while clinical staff may be released from separate documentation tasks. However, the results of this study indicate that the reliability of time stamps is affected by implausible entries and several uncertainties. The quality of time stamp documentation in German hospital administrative data might be improved by setting incentives for correct documentation and by setting out definite specifications of time points, such as time of admission.
MeSH term(s)	Germany/epidemiology ; Hospitals ; Humans ; Percutaneous Coronary Intervention ; Reproducibility of Results ; Risk Factors ; ST Elevation Myocardial Infarction/therapy ; Treatment Outcome
Language	German
Publishing date	2021-10-25
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1101426-x
ISSN	1439-4421 ; 0941-3790 ; 0949-7013
ISSN (online)	1439-4421
ISSN	0941-3790 ; 0949-7013
DOI	10.1055/a-1557-1130
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Article ; Online: Disease-Specific Trends of Comorbidity Coding and Implications for Risk Adjustment in Hospital Administrative Data.

Nimptsch, Ulrike

Health services research

2016 Volume 51, Issue 3, Page(s) 981–1001

Abstract: Objective: To investigate changes in comorbidity coding after the introduction of diagnosis related groups (DRGs) based prospective payment and whether trends differ regarding specific comorbidities.: Data sources: Nationwide administrative data (DRG ...

Abstract	Objective: To investigate changes in comorbidity coding after the introduction of diagnosis related groups (DRGs) based prospective payment and whether trends differ regarding specific comorbidities. Data sources: Nationwide administrative data (DRG statistics) from German acute care hospitals from 2005 to 2012. Study design: Observational study to analyze trends in comorbidity coding in patients hospitalized for common primary diseases and the effects on comorbidity-related risk of in-hospital death. Extraction methods: Comorbidity coding was operationalized by Elixhauser diagnosis groups. The analyses focused on adult patients hospitalized for the primary diseases of heart failure, stroke, and pneumonia, as well as hip fracture. Principal findings: When focusing the total frequency of diagnosis groups per record, an increase in depth of coding was observed. Between-hospital variations in depth of coding were present throughout the observation period. Specific comorbidity increases were observed in 15 of the 31 diagnosis groups, and decreases in comorbidity were observed for 11 groups. In patients hospitalized for heart failure, shifts of comorbidity-related risk of in-hospital death occurred in nine diagnosis groups, in which eight groups were directed toward the null. Conclusions: Comorbidity-adjusted outcomes in longitudinal administrative data analyses may be biased by nonconstant risk over time, changes in completeness of coding, and between-hospital variations in coding. Accounting for such issues is important when the respective observation period coincides with changes in the reimbursement system or other conditions that are likely to alter clinical coding practice.
MeSH term(s)	Age Factors ; Aged ; Aged, 80 and over ; Clinical Coding/trends ; Comorbidity ; Diagnosis-Related Groups/trends ; Female ; Germany ; Heart Failure/complications ; Heart Failure/mortality ; Hip Fractures/complications ; Hip Fractures/mortality ; Hospital Mortality/trends ; Hospitals/trends ; Humans ; Length of Stay ; Male ; Middle Aged ; Pneumonia/complications ; Pneumonia/mortality ; Prospective Payment System/trends ; Risk Adjustment/trends ; Sex Factors ; Stroke/complications ; Stroke/mortality
Language	English
Publishing date	2016-06
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	410435-3
ISSN	1475-6773 ; 0017-9124
ISSN (online)	1475-6773
ISSN	0017-9124
DOI	10.1111/1475-6773.12398
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