R e v i s i o n s i n H e a l t h I n s t i t u t i o n s P r o v i d i n g I n - p a t i e n t A f t e r c a r e - C a s e - r e c o r d

Overview

The submitted case-record draws attention to the problem of revising the justification of hospital admission of insurants whenfrom the documentation it is not apparent why in-patient health care must be provided instead of ambulatory care. The authorspresent basic data and analyses preceding the revision proper as well as the Record of facts revealed by the revision, theconclusion and evaluation of the revision incl. its economic outcome. In the evaluation of results it does not only draw attentionto the violation of valid legal norms but in particular to many important errors in the documentation on provided health carewith an impact on its quality. Finally the authors evaluate the impact of thus implemented revisions on the organization andimplementation of revision activities and relations between the health insurance company and the revised health department.

Key words:
revision activities - revision (control part of revision activities) - in-patient aftercare - remedial rehabilitation - nursingtype beds - in- and out- patient health care - revision group