[Referral and management in geriatrics and geriatric rehabilitation with special reference to medical case fee schedules and diagnosis related groups (DRGs)].

Every system of payment of flat-rate case charges results in an economically determined optimizing of treatment processes. This presupposes a high level of co-operation between all those involved in the treatment process. Collaboration must extend over occupational groups (doctors, nursing staff and therapists), over departments (specialist geriatric competence and specialist knowledge) and must increasingly take place in a manner extending over sectors (inpatient, partly inpatient and outpatient). To this end, interdisciplinary, team-oriented modes of working provide the direction to be followed in geriatrics. What is essential for efficient patient management is for patient allocation control to be implemented in good time, with individual requirements regarding treatment being provided by the most suitable department. This will only be possible, in perspective, by implementing binding treatment guidelines and quality standards, as well as the timely interdisciplinary incorporation of acute geriatrics, e.g. by participation of the admission wards of the clinics. Geriatrics in acute hospitals has demonstrated its value and has become an indispensable element of appropriate health provision in Germany. The retention of this structure of geriatric care presupposes that, in the future, the DRG system of geriatric services will also be included with a sufficient measure of differentiation and that consequently an appropriate level of remuneration for geriatric services will be ensured. As the DRG system has not been applied internationally, up until now, in the area of acute geriatrics, suitable adjustments to the system of the basic Australian AR-DRG system are absolutely essential.