Physiotherapy as one column of an integrative and interdisciplinary medical approach-Impact of the introduction of diagnosis related groups in Germany

SummaryObjectivesTo investigate the introduction of case tariff fee remuneration - as required by the current system - and its influence on patient satisfaction with the provision of physiotherapeutic treatment in an acute hospital aligned on a holistic, interdisciplinary therapeutic approach.Design and settingRandomised controlled study with a total of 4598 patients were interviewed. No case tariff fee system was used during the years 2004 to 2006. The data were compared with the results of interviews that took place during 2007 and 2008 (use of DRGs). The results of this study are based on the largest survey performed to date of patient satisfaction with physiotherapeutic treatment in acute care focusing on a holistic interdisciplinary approach. In-patients being treated under DRG conditions were compared with a control group for whom the DRG system had not been applied.Outcome measuresThe target parameter of the study, which took more than five years, was the determination of patient satisfaction with the physiotherapeutic interventions.ResultsThere were no significant differences between the two groups in respect of satisfaction with the physiotherapeutic treatments received. Regarding the outcome parameter encouragement to take more exercise, a significant change could be demonstrated under DRG conditions.ConclusionsPhysiotherapeutic interventions play an important role in the provision of interdisciplinary care. In particular, the holistic perception of the patient, the interdisciplinary approach to complex diseases, and the requirements of the DRG system on the care provider can exert a positive influence on outcome quality.