Inpatient hospital costs and length of stay for the treatment of affective and somatoform disorders - evidence from Germany

Interoceptive accuracy and bias in somatic symptom disorder, illness anxiety disorder, and functional syndromes: A systematic review and meta-analysis

Somatic symptom disorder, illness anxiety disorder, and functional syndromes are characterized by burdensome preoccupation with somatic symptoms. Etiological models propose either increased interoceptive accuracy through hypervigilance to the body, or decreased and biased interoception through top-down predictions about sensory events. This systematic review and meta-analysis summarizes findings of 68 studies examining interoceptive accuracy and 8 studies examining response biases in clinical or non-clinical groups. Analyses yielded a medium population effect size for decreased interoceptive accuracy in functional syndromes, but no observable effect in somatic symptom disorder and illness anxiety disorder. The overall effect size was highly heterogeneous. Regarding response bias, there was a small significant effect in somatic symptom disorder and illness anxiety disorder. Our findings strengthen the notion of top-down factors that result in biased rather than accurate perception of body signals in somatic symptom disorder and illness anxiety disorder.

Levels of Patient Satisfaction on Integrative Medicine Before and After Implementation of Diagnosis-related Groups

OBJECTIVES

The aim of this article is to study patient satisfaction with complementary and alternative medicine (CAM) in an in-hospital setting before and after the introduction of diagnosis-related groups (DRGs).

METHODS

Patients were interviewed regarding a general evaluation of their hospital stay, the psychological talking therapy, the nutrition therapy, and the overall success of the treatment.

RESULTS

The medical treatment was evaluated by 1158 patients. A very good success was reported by 347, a good by 609, a moderate by 181, and none by 21 patients. DRG implementation showed no significant effects. Psychological talking therapy was evaluated as "very good" (P ≤ .05). With regard to the success of the medical talking and nutrition therapy, there were no significant differences (P ≥ .05) between the time before and after DRG implementation.

CONCLUSION

Broadening conventional medical treatment with CAM practices can lead to a parallel treatment of DRGs in hospitals working with complementary medicine. This results in very patient-centered therapies, which may impact patient satisfaction.

Comparative cost analysis of inpatient integrative medicine-Results of a pilot study

BACKGROUND

Costs of integrative treatment alone and in comparison with other treatment approaches have scarcely been reported in the past. This study presents results of a comparative cost analysis of an inpatient integrative medicine treatment costs.

METHODS

Data from 2006 for inpatients referred to a Department of Integrative Medicine in Germany were used. Case-related treatment costs were calculated, and transformed into Casemix-Indices and revenues per DRG. Costs were compared between departments at the same hospital and between different hospitals using univariate statistics and Chi-Square tests.

RESULTS

In total 1253 inpatients (81.4% female, 61.1±14.4years) were included in the current analysis. Most patients were treated for diseases of the musculoskeletal system (57.2%), followed by diseases of the digestive system (11.4%), and diseases of the nervous system (10.4%). The department received an additional payment for most of the patients (88.0%), which led to an effective appreciation of 10.8% per case compared to the standardized Casemix-Index. In-house comparisons with other departments found the department in close vicinity to the departments of Internal medicine with regards to CMI and mean revenue, however the Patient Clinical Complexity Level was significantly lower in the Integrative medicine department. The interhospital comparison revealed comparable Casemix-Index and DRG-revenue, however the additional payment increased the mean revenue significantly.

CONCLUSION

Modern integrative in-patient treatment is mostly cost-equivalent to conventional treatment. Cost effectiveness studies should be considered to further investigate the potential of integrative in patient treatment.