Inpatient Care of Parkinson’s Disease in Germany: A Study of Costs and Length of Stay With Particular Reference to an Interdisciplinary Approach

This article describes outcomes of the complex therapy of Parkinson’s disease according to Operation and Procedure Code 8-97d, an interdisciplinary approach to the treatment of Morbus Parkinson established in Germany. The code defines mandatory minimum requirements for the organizational structures and processes of hospital treatment. The aim of the study was to analyze profession-related treatment costs, accompanying diseases and hospitalization times for inpatient Parkinson therapy and to compare these for interdisciplinary versus conventional approaches. A structured procedure analysis was carried out. Indication-based cost calculations and an analysis of secondary diagnoses were performed. In addition to the primary diagnosis of Parkinson’s disease, all patients surveyed are suffering from further diseases in Major Diagnostic Category (MDC) 1, 5, 6, 10, 11, and 23. Among the patients surveyed who were receiving complex therapy, secondary diagnoses falling into MDC 8 dominated. The average hospitalization time for those patients receiving interdisciplinary treatment for Parkinson’s disease was 18.16 days, significantly longer than the 12.01 days for the comparison group. Analysis of the costs revealed significant differences in the total costs of medical service and in the personnel and operating costs of nonmedical infrastructure. The high standards demanded of the hospital structure for the provision of interdisciplinary services, together with a prescribed therapy density including quality assurance assessments, result in patients being hospitalized for longer; this is reflected in higher costs. Treatment of Parkinson’s patients should not only include the primary disease but also any accompanying diseases. For this, appropriate reimbursement higher than for the conventional Parkinson’s diagnosis-related group (DRG) is needed.