Head-to-head comparison of length of stay, patients' outcome and satisfaction in Switzerland before and after SwissDRG-Implementation in 2012 in 2012: an observational study in two tertiary university centers.

On 1 January 2012 Swiss Diagnosis Related Groups (DRG), a new uniform payment system for in-patients was introduced in Switzerland with the intention to replace a "cost-based" with a "case-based" reimbursement system to increase efficiency. With the introduction of the new payment system we aim to answer questions raised regarding length of stay as well as patients' outcome and satisfaction. This is a prospective, two-centre observational cohort study with data from University Hospital Basel and the Cantonal Hospital Aarau, Switzerland, from January to June 2011 and 2012, respectively. Consecutive in-patients with the main diagnosis of either community-acquired pneumonia, exacerbation of COPD, acute heart failure or hip fracture were included. A questionnaire survey was sent out after discharge investigating changes before and after SwissDRG implementation. Our primary endpoint was LOS. Of 1,983 eligible patients 841 returned the questionnaire and were included into the analysis (429 in 2011, 412 in 2012). The median age was 76.7 years (50.8% male). Patients in the two years were well balanced in regard to main diagnoses and co-morbidities. Mean LOS in the overall patient population was 10.0 days and comparable between the 2011 cohort and the 2012 cohort (9.7 vs 10.3; p = 0.43). Overall satisfaction with care changed only slightly after introduction of SwissDRG and remained high (89.0% vs 87.8%; p = 0.429). Investigating the influence of the implementation of SwissDRG in 2012 regarding LOS patients' outcome and satisfaction, we found no significant changes. However, we observed some noteworthy trends, which should be monitored closely.

The Iowa Perinatal Letter, April-May-June 2007, Vol. 28, no.2

This newsletter from The Department of Public Health about perinatal health care and statistics.

The Iowa Perinatal Letter, July-August-September 2007, Vol. 28, no.3

This newsletter from The Department of Public Health about perinatal health care and statistics.

The Iowa Perinatal Letter, October-November-December 2007, Vol. 28, no. 4

This newsletter from The Department of Public Health about perinatal health care and statistics.

The Iowa Perinatal Letter, January-February-March 2008, Vol. 29, no. 1

This newsletter from The Department of Public Health about perinatal health care and statistics.

The Iowa Perinatal Letter, April-May-June 2008, Vol. 29, no. 2

This newsletter from The Department of Public Health about perinatal health care and statistics.

The Iowa Perinatal Letter, July-August-September 2008, Vol. 29, no. 3

This newsletter from The Department of Public Health about perinatal health care and statistics.

The Iowa Perinatal Letter, October-November-December 2008, Vol. 29, no. 4

This newsletter from The Department of Public Health about perinatal health care and statistics.

The Iowa Perinatal Letter, January-February-March 2009, Vol. 30, no. 1

This newsletter from The Department of Public Health about perinatal health care and statistics.

The Iowa Perinatal Letter, April-May-June 2009, Vol. 30, no. 2

This newsletter from The Department of Public Health about perinatal health care and statistics.

The Iowa Perinatal Letter, July-August-September 2009, Vol. 30, no. 3

This newsletter from The Department of Public Health about perinatal health care and statistics.

The Iowa Perinatal Letter, October-November-December 2009, Vol. 30, no. 4

This newsletter from The Department of Public Health about perinatal health care and statistics.

The Iowa Perinatal Letter, January-February-March 2010, Vol. 31, no. 1

This newsletter from The Department of Public Health about perinatal health care and statistics.

The Iowa Perinatal Letter, April-May-June 2010, Vol. 31, no. 2

This newsletter from The Department of Public Health about perinatal health care and statistics.

Parental post-traumatic reactions after premature birth: implications for sleeping and eating problems in the infant.

BACKGROUND: Progress in perinatal medicine has made it possible to increase the survival of very or extremely low birthweight infants. Developmental outcomes of surviving preterm infants have been analysed at the paediatric, neurological, cognitive, and behavioural levels, and a series of perinatal and environmental risk factors have been identified. The threat to the child's survival and invasive medical procedures can be very traumatic for the parents. Few empirical reports have considered post-traumatic stress reactions of the parents as a possible variable affecting a child's outcome. Some studies have described sleeping and eating problems as related to prematurity; these problems are especially critical for the parents. OBJECTIVE: To examine the effects of post-traumatic reactions of the parents on sleeping and eating problems of the children. DESIGN: Fifty families with a premature infant (25-33 gestation weeks) and a control group of 25 families with a full term infant participated in the study. Perinatal risks were evaluated during the hospital stay. Mothers and fathers were interviewed when their children were 18 months old about the child's problems and filled in a perinatal post-traumatic stress disorder questionnaire (PPQ). RESULTS: The severity of the perinatal risks only partly predicts a child's problems. Independently of the perinatal risks, the intensity of the post-traumatic reactions of the parents is an important predictor of these problems. CONCLUSIONS: These findings suggest that the parental response to premature birth mediates the risks of later adverse outcomes. Preventive intervention should be promoted.