PMID- 20577642
OWN - NLM
STAT- MEDLINE
DCOM- 20100929
LR  - 20221207
IS  - 1612-3174 (Electronic)
IS  - 1612-3174 (Linking)
VI  - 8
DP  - 2010 Jun 15
TI  - Cost analysis of Topical Negative Pressure (TNP) Therapy for traumatic acquired 
      wounds.
PG  - Doc13
LID - 10.3205/000102 [doi]
LID - Doc13
AB  - Extended traumatic wounds require extended reconstructive operations and are 
      accompanied by long hospitalizations and risks of infection, thrombosis and flap 
      loss. In particular, the frequently used Topical Negative Pressure (TNP) Therapy 
      is regarded as cost-intensive. The costs of TNP in the context of traumatic 
      wounds is analyzed using the method of health economic evaluation. All patients 
      (n=67: 45 male, 22 female; average age 54 y) with traumatically acquired wounds 
      being treated with TNP at the university hospital of Goettingen in the period 
      01/01/2005-31/12/2007 comprise the basis for this analysis. The concept of 
      activity-based costing based on clinical pathways according to InEK (National 
      Institute for the Hospital Remuneration System) systematic calculations was 
      chosen for cost accounting. In addition, a special module system adaptable for 
      individual courses of disease was developed. The treated wounds were located on a 
      lower extremity in 83.7% of cases (n=56) and on an upper extremity in 16.3% of 
      cases (n=11). The average time of hospitalization of the patients was 54 days. 
      Twenty-five patients (37.31%) exceeded the "maximum length of stay" of their 
      associated DRG (Diagnosis Related Groups). The total PCCL (patient clinical 
      complexity level = patient severity score) of 2.99 reflects the seriousness of 
      disease. For the treatment of the 67 patients, total costs were $1,729,922.32 
      (1,249,176.91 euro). The cost calculation showed a financial deficit of 
      $-210,932.50 (-152,314.36 euro). Within the entire treatment costs of $218,848.07 
      (158,030.19 euro), 12.65% per case were created by TNP with material costs of 
      $102,528.74 (74,036 euro), representing 5.92% of entire costs. The cost of TNP 
      per patient averaged $3,266.39 (2,358.66 euro). The main portion of the costs was 
      not - as is often expected - due to high material costs of TNP but instead to 
      long-term treatments. Because of their complexity, the cases are insufficiently 
      represented in the lump-sum calculation of the InEK. A differentiated integration 
      of complex TNP-treatment in the DRG system (e.g., as an expanded DRG I98Z) would 
      be a step towards cost recovery. In addition, the refunding of outpatient 
      TNP-treatment would lead to enhanced quality of life for the patients and to a 
      reduction of hospital costs and length of stay.
FAU - Kolios, Leila
AU  - Kolios L
AD  - Department of Trauma Surgery, Plastic and Reconstructive Surgery, University of 
      Goettingen, D-37075 Goettingen, Germany. leilakolios@freenet.de
FAU - Kolios, Georg
AU  - Kolios G
FAU - Beyersdorff, Marius
AU  - Beyersdorff M
FAU - Dumont, Clemens
AU  - Dumont C
FAU - Stromps, Jan
AU  - Stromps J
FAU - Freytag, Sebastian
AU  - Freytag S
FAU - Stuermer, Klaus
AU  - Stuermer K
LA  - eng
PT  - Journal Article
DEP - 20100615
PL  - Germany
TA  - Ger Med Sci
JT  - German medical science : GMS e-journal
JID - 101227686
SB  - IM
MH  - Costs and Cost Analysis
MH  - Female
MH  - Germany
MH  - *Hospital Costs
MH  - Hospitalization/economics
MH  - Humans
MH  - Infections/economics
MH  - Length of Stay/economics
MH  - Male
MH  - Middle Aged
MH  - Negative-Pressure Wound Therapy/*economics/nursing
MH  - Nursing Staff, Hospital/economics
MH  - Plastic Surgery Procedures/economics
MH  - Surgical Flaps/economics
MH  - Thrombosis/economics
MH  - Wounds and Injuries/*economics/nursing/*therapy
PMC - PMC2890208
OTO - NOTNLM
OT  - cost analysis
OT  - economic evaluation
OT  - topical negative pressure therapy (TNP)
OT  - traumatic wound
OT  - vacuum assisted closure (VAC)
EDAT- 2010/06/26 06:00
MHDA- 2010/09/30 06:00
PMCR- 2010/06/15
CRDT- 2010/06/26 06:00
PHST- 2009/12/12 00:00 [received]
PHST- 2010/03/24 00:00 [revised]
PHST- 2010/06/26 06:00 [entrez]
PHST- 2010/06/26 06:00 [pubmed]
PHST- 2010/09/30 06:00 [medline]
PHST- 2010/06/15 00:00 [pmc-release]
AID - 000102 [pii]
AID - 13 [pii]
AID - 10.3205/000102 [doi]
PST - epublish
SO  - Ger Med Sci. 2010 Jun 15;8:Doc13. doi: 10.3205/000102.