Search

Hintergrund: Durch die Erfassung von Diagnosen und DRGs lässt sich deren Verteilung im Jahresverlauf ableiten. Saisonale Häufungen von Erkrankungen können identifiziert und Ressourcen entsprechend geplant werden.Methodik: Zwischen 2006 und 2016 wurden 30.999 Hauptdiagnosen und DRGs an der viszeralchirurgischen Klinik des Uniklinikums Leipzig erfasst. Diese wurden auf Monats- und Jahreszeitenebene aggregiert und Daten des Deutschen Wetterdienstes gegenübergestellt. Parallel erfassten wir epidemiologische Daten der Patienten.Ergebnis: Häufigste Hauptdiagnosegruppe ist C22 („Bösartige Neubildung der Leber und der intrahepatischen Gallengänge", 1589 Fälle) gefolgt von K35 („Akute Appendizitis", 1557 Fälle). Signifikante saisonale Verteilungsschwankungen zeigten sich für K80 („Cholelithiasis", 1013 Fälle, p = 0,002++), K40 („Hernia inguinalis", 887 Fälle, p = 0,002++), K43 („Hernia ventralis", 696 Fälle, p < 0,001++), und I83 („Varizen der unteren Extremitäten", 352 Fälle, p < 0,001++). Analog dieser Verteilung ergibt sich eine Korrelation zwischen Sonnenscheindauer und Fallzahl für Patienten mit der Hauptdiagnosegruppe I83 (r = −0,12, p = 0,036+) sowie K43 (r = −0,08, p = 0,041+). Hochsignifikante Korrelationen ergaben sich für epidemiologische Daten und Behandlungsdaten der Patienten: patientenbezogener klinischer Schweregrad (PCCL) ~ Alter (r = 0,27, p < 0,001++), Verweildauer ~ Alter (r = 0,25, p < 0,001++), Beatmungsdauer ~ Alter (r = 0,07, p < 0,001++) sowie Mortalität ~ Alter (r = 0,09, p < 0,001++).Diskussion: Von der Variabilität der Fallzahlen einzelner Hauptdiagnosen sind maßgeblich elektive und damit planbare Aufnahmen betroffen. Eine adäquate Ressourcensteuerung kann ökonomische Vorteile bergen. Älteren Patienten ist nicht zuletzt aufgrund des hohen Ressourcenverbrauchs besondere Aufmerksamkeit zu schenken. [ABSTRACT FROM AUTHOR]

Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) offers patients with peritoneal cancer of various origins the chance of a relevant increase in life expectancy. These cases are very complex from a medical viewpoint and very expensive from an economical aspect. An analysis of case cost calculations was performed to find out whether this procedure can on average be carried out cost-effectively by a maximum care university. Materials and methods: All cases from 2008 in which HIPEC was carried out were analyzed. The types of main diagnosis, secondary diagnoses, procedures, times from incision to suture and hospital stay were analyzed. On the basis of the case costs the proceeds and marginal returns were calculated from the diagnosis-related groups (DRGs) and additional remuneration when applicable. The causes of positive and negative marginal returns were explained using the InEK cost matrix. Results: In 18 patients there were 9 different main diagnoses and 7 different 'main procedures' (from a surgical perspective the most resource intensive procedures) and a total of 10 different DRGs were identified in the grouping algorithm. With an average of 2 operations (range 1-7) per patient the summed incision-to-suture time was 423 min (170-962 min). The patients stayed on average 6.4 days (1.3-17.6 days) in intensive care. The average case cost was 21,072€ (range 8,657-55,904€) and the proceeds 20,474€ (6,333-37,497€). Each case had on average a debit balance of 598€ (range from 11,843€ profit balance to 18,407€ debit balance) with an assumed base rate of 2,786€. The causes for positive or negative marginal profits were mostly operating times, incision-to-suture times and duration of intensive care. Conclusions: The proceeds showed on average a deficit of only 3% compared to the costs. The operating times must be decreased by optimization particularly of the preoperative approach. Interventions should be carried out in one stage only and the intraoperative connecting and waiting times should be reduced in order to reduce the incision-to-suture times. [ABSTRACT FROM AUTHOR]