Background: Since 2012, Swiss inpatient dermatology is funded through a flat rate payment system based on diagnosis-related groups (DRGs). Objective: To analyze the reimbursement of nonsurgically treated severe disorders of the skin under the system called SwissDRG. Methods: Three retrospective, cross-sectional cohort studies were performed. Data sets were received from the Swiss Federal Office of Statistics (1,285,685 retained records), the five Swiss university hospitals (370,964 retained records) and our center (72,211 retained records). Results: Cases accounted for 0.04% of all hospitalizations nationwide, with 43.7% treated at university hospitals. Treatment at university hospitals produced a mean loss of USD 3,711 per case. Lyell syndrome cases were especially underfunded (mean loss USD 31,906). Extra-county admissions and direct referrals were significant predictors of total inpatient costs (p = 0.019 and p < 0.001, respectively). Conclusions: We suggest grouping Lyell syndrome cases into burn DRGs and evaluating extra-county admissions and direct inpatient referrals as DRG split criteria.

Bickers DR, Lim HW, Margolis D, Weinstock MA, Goodman C, Faulkner E, Gould C, Gemmen E, Dall T; American Academy of Dermatology Association; Society for Investigative Dermatology: The burden of skin diseases: 2004 a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology. J Am Acad Dermatol 2006;55:490-500.
Navarini AA, Laffitte E, Conrad C, Piffaretti P, Brock E, Ruckdaeschel S, Trueb RM: Estimation of cost-of-illness in patients with psoriasis in Switzerland. Swiss Med Wkly 2010;140:85-91.
Hensen P, Beissert S, Bruckner-Tuderman L, Luger TA, Roeder N, Muller ML: Introduction of diagnosis-related groups in Germany: evaluation of impact on in-patient care in a dermatological setting. Eur J Public Health 2008;18:85-91.
Wenke A, Muller ML, Babapirali J, Rompel R, Hensen P: Development of lengths of stay and DRG cost weights in dermatology from 2003 to 2006. J Dtsch Dermatol Ges 2009;7:680-687.
Treudler R, Meier F, Schoffski O, Simon JC: Has the DRG system impacted on inpatient allergy care in university dermatology departments in Germany? J Dtsch Dermatol Ges 2012;10:808-812.
Furstenberg T, Rompel R, Gollnick H, Sterry W, Luger TA, Hensen P, Roeder N: DRGs in dermatology: results of the DRG evaluation project of the German Society of Dermatology (DDG). J Dtsch Dermatol Ges 2004;2:24-30.
REKOLE® Handbuch: Betriebliches Rechnungswesen im Spital, ed 3. Bern, REKOLE, 2014.
IBM Corporation: IBM SPSS Statistics for Windows. Armonk, IBM Corp., 2013.
Vogl M: Assessing DRG cost accounting with respect to resource allocation and tariff calculation: the case of Germany. Health Econ Rev 2012;2:15.
Bundesamt für Statistik (BFS): Statistik diagnosebezogener Fallkosten 2012, 2014.
Hartman M, Prins M, Swinkels OQ, Severens JL, De Boo T, Van Der Wilt GJ, Van De Kerkhof PC, Van Der Valk PG: Cost-effectiveness analysis of a psoriasis care instruction programme with dithranol compared with UVB phototherapy and inpatient dithranol treatment. Br J Dermatol 2002;147:538-544.
WHO: International Classification of Diseases and Related Health Problems, ed 10, rev. Geneva, WHO, 2015.
Roujeau JC: Stevens-Johnson syndrome and toxic epidermal necrolysis are severity variants of the same disease which differs from erythema multiforme. J Dermatol 1997;24:726-729.
Auquier-Dunant A, Mockenhaupt M, Naldi L, Correia O, Schroder W, Roujeau JC; SCAR Study Group - Severe Cutaneous Adverse Reactions: Correlations between clinical patterns and causes of erythema multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis: results of an international prospective study. Arch Dermatol 2002;138:1019-1024.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.