Large variations in the classification of cholecystectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons, hospital managers and national DRG authorities should consider how other countries' DRG systems classify cholecystectomy patients in order to optimize their DRG systems and to ensure fair and appropriate reimbursement.

Cholecystectomy is the surgical removal of the gallbladder. It is the most common method for treating symptomatic gallstones. Despite the existence of well-established treatment guidelines, the rate of cholecystectomy varies widely across Europe. We analyse patients in 10 countries that had undergone surgery for the treatment of symptomatic gallstones. We test the performance of three models in explaining variation in the (log of) cost of the inpatient stay (seven countries) or length of stay (three countries). The first model includes only the diagnosis-related group (DRG) variables to which cholecystectomy patients were coded (M D ), the second uses a core set of patient characteristics and episode-specific explanatory variables (M P ), and finally, the third model combines both sets of variables (M F ). Countries vary both in the number of DRGs used to classify cholecystectomy patients (range: 2-8), and in the percentage of patients covered by a single DRG (range: 50%-92%). The ability of combining both DRGs and patient level variables to explain cost variation among patients ranges from 58% in Spain to over 81% in Finland. The comparison of models' performance suggests that incorporating relevant patient characteristics may significantly improve DRG systems.

The Agency for Health Technology Assessment and Tariff System is national institution supervised by Minister of Health. Agency is an advisory body in the reimbursement process. One of the Agency’s roles is setting a tariff for publicly funded healthcare services. Determining the cost of medical services is one of the most important conditions for valuating these tariffs. As in most European countries, the system of financing in-patient care in Poland is based on the Diagnosis Related Group system (DRG). DRG systems were created to increase efficiency in the use of available resources, and consequently to improve the quality of medical care. In order to compare the method and level of financing healthcare services with their equivalent abroad, the Agency analyzes information from other countries, especially those with GDP per capita similar to that of Poland. The Agency searches for patient group classification methods, payment methods, the shape of services and all factors affecting the valuation of services. The article describes the Polish inpatient services system against the background of solutions functioning in the world. The pricing process was presented, with particular emphasis on the process of obtaining data on foreign tariffs and their impact on the construction and pricing of healthcare services in Poland.

Dass Feinstaub in Gebäuden der Gesundheit schaden kann, ist bekannt. Partikelfilter in Raumlufttechnischen Anlagen können die Feinstaubkonzentration reduzieren und nach der neuen DIN EN ISO 16890–1 jetzt zielgerichtet für den Aufstellungsort und die spezifischen Umgebungsbedingungen ausgelegt werden. Das verbessert die Luftqualität, erhöht die Energieeffizienz, hilft der Gesunderhaltung der Menschen und schafft Planungssicherheit.

Die Norm DIN EN 1886 1) wurde in ihrer ersten Version im Jahr 1998 herausgegeben. Im Zuge der Überarbeitung erfolgte die zweite Veröffentlichung im Jahr 2007. Die Norm ist somit schon seit mehr als 20 Jahren Stand der Technik und dient als Referenz zur Beurteilung thermischer Kennwerte von RLT-Gerätegehäusen. In diesem Fachbericht werden im Speziellen der Wärmedurchgang und die Kältebrücken der Konstruktion betrachtet.