PMID- 23027336
OWN - NLM
STAT- MEDLINE
DCOM- 20130417
LR  - 20141120
IS  - 1439-3980 (Electronic)
IS  - 0722-1819 (Linking)
VI  - 44
IP  - 5
DP  - 2012 Oct
TI  - [Development of length of stay and reimbursement in elective hand surgery after 
      the introduction of DRGs in Germany].
PG  - 306-9
LID - 10.1055/s-0032-1323712 [doi]
AB  - BACKGROUND: Since its introduction in Germany, the DRG (Diagnosis-Related Groups) 
      system is often fraught with negative connotations. Frequent points of criticism 
      are a deterioration of patient care by decreasing length of stay (LOS) in 
      hospital and a decline in reimbursement. The following investigation analyzes and 
      compares the development of length of stay and reimbursement in hand surgery 
      based on the 3 most common elective procedures. MATERIAL AND METHODS: The main 
      diagnoses scaphoid nonunion (PSA), Dupuytren's contracture (DK) and rhizarthrosis 
      (RIA) were evaluated for number of cases, length of stay, reimbursement per day 
      and total reimbursement in 2000 as well as 2010 based on the data of our clinic. 
      Patients covered by the Employers' Liability Insurance were not included. Only 
      inpatient cases were considered. RESULTS: In PSA and RIA an increase in the 
      number of cases is reported (PSA: +11 cases; RIA: +26 cases) and a decrease in DK 
      ( - 7 cases). The sum of the total hospital days declined despite rising case 
      numbers predominantly between 65 (RIA) and 260 days (DK). The average LOS 
      decreased by 3.1 days at DK (48.4%) to 4.1 days at PSA (52.6%). Average revenues 
      per day in 2000 amounted to 379 euro, which corresponds to 442 euro adjusted for 
      inflation in 2010. Average revenue per day in 2010 was 755 euro (RIA), 797 euro (PSA) 
      and 876 euro (DK). Revenue per case in 2010 were only higher than in 2000, when 5 
      (RIA) or 6 hospital days (DK and PSA) were not exceeded. CONCLUSION: With 
      declining revenue per case, the average income per day increased by a reduction 
      in hospital days. A positive or at least equivalent revenue situation can thus 
      only be achieved by a distinct concentration of labor and reduction of hospital 
      days under the DRG-system.
CI  - (c) Georg Thieme Verlag KG Stuttgart . New York.
FAU - Gonser, P
AU  - Gonser P
AD  - Abteilung fur Hand-, Plastische, rekonstruktive und Verbrennungschirurgie, BG 
      Unfallklinik Tubingen, Eberhard Karls Universitat Tubingen. 
      pgonser@bgu-tuebingen.de
FAU - Lotter, O
AU  - Lotter O
FAU - Schaller, H-E
AU  - Schaller HE
FAU - Jaminet, P
AU  - Jaminet P
LA  - ger
PT  - English Abstract
PT  - Journal Article
TT  - Entwicklung von Verweildauer und Vergutung handchirurgischer Elektiveingriffe 
      durch Einfuhrung der DRGs in Deutschland.
DEP - 20121001
PL  - Germany
TA  - Handchir Mikrochir Plast Chir
JT  - Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen 
      Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen 
      Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ 
      der V...
JID - 8302815
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cost-Benefit Analysis/economics/trends
MH  - Dupuytren Contracture/*economics/*surgery
MH  - Elective Surgical Procedures/*economics/*trends
MH  - Fee Schedules/economics/trends
MH  - Female
MH  - Forecasting
MH  - Fractures, Ununited/*economics/*surgery
MH  - Germany
MH  - Hand/*surgery
MH  - Hospital Costs/trends
MH  - Humans
MH  - Income
MH  - Length of Stay/*economics/*trends
MH  - Male
MH  - Middle Aged
MH  - National Health Programs/*economics/*trends
MH  - Osteoarthritis/*economics/*surgery
MH  - Reimbursement Mechanisms/*economics/*trends
MH  - Scaphoid Bone/*surgery
MH  - Wrist Joint/*surgery
EDAT- 2012/10/03 06:00
MHDA- 2013/04/18 06:00
CRDT- 2012/10/03 06:00
PHST- 2012/10/03 06:00 [entrez]
PHST- 2012/10/03 06:00 [pubmed]
PHST- 2013/04/18 06:00 [medline]
AID - 10.1055/s-0032-1323712 [doi]
PST - ppublish
SO  - Handchir Mikrochir Plast Chir. 2012 Oct;44(5):306-9. doi: 10.1055/s-0032-1323712. 
      Epub 2012 Oct 1.