PMID- 27547931
OWN - NLM
STAT- MEDLINE
DCOM- 20180411
LR  - 20181202
IS  - 1439-3980 (Electronic)
IS  - 0722-1819 (Linking)
VI  - 48
IP  - 4
DP  - 2016 Aug
TI  - [Analysis of Diagnosis Related Groups and their Impact on Health Care in Post 
      Massive Weight Loss Surgery].
PG  - 226-32
LID - 10.1055/s-0042-110568 [doi]
AB  - BACKGROUND: Diagnosis Related Groups (DRG) were introduced in Germany as a 
      medico-economic classification system in 2004. In this analysis, we looked at 
      restorative surgery after massive weight loss, focusing on reimbursement of this 
      fee-per-case system in comparison to costs to deduce possible effects on health 
      care over time. MATERIAL AND METHODS: First we analysed the algorithms for the 
      relevant DRGs including data about length of stay and reimbursement. Furthermore, 
      we integrated cost data from German reference hospitals of the last 5 years as 
      well as single-centre data from a university hospital. RESULTS: Due to a 
      diagnosis-related algorithm, coding will constantly lead to DRG K07Z. In 2016, a 
      new diagnosis code specific to massive weight loss was introduced, which now 
      leads to DRG J10B. As a result, reimbursement is reduced by more than half. In 
      the cost matrix, staff, general ward, operation theatre and anaesthesia were 
      identified as the main cost drivers. As expected, there was a statistically 
      significant correlation between general ward costs and time of stay in hospital 
      as well as operation theatre costs and incision-suture time. Considering the cost 
      data of the reference hospitals, there was an average excess of EUR 781 per case 
      whereas our own cost data revealed a deficit of EUR 1 700 to 2 700 per case. This 
      is mainly due to the fact that approximately one third of our patient cohort 
      underwent highly elaborate circular body lifts. CONCLUSION: It has to be 
      questioned whether a newly introduced main diagnosis code can be applied as such 
      without any underlying cost data having been collected in previous years. Given 
      unchanged treatment measures, the main cost drivers identified by us remain the 
      same, which means that there is no rationale for a drop in revenue. In addition 
      to providing incentives for an efficient use of resources and quality 
      optimisation, this system should offer medical service providers a sustainable 
      and realistic possibility to break even.
CI  - (c) Georg Thieme Verlag KG Stuttgart . New York.
FAU - Lotter, O
AU  - Lotter O
AD  - Klinik fur Plastische, Asthetische, Hand- und Wiederherstellungschirurgie, 
      Klinikum Landkreis Tuttlingen.
FAU - Hoefert, S
AU  - Hoefert S
AD  - Klinik fur Mund-, Kiefer- und Gesichtschirurgie an der 
      Eberhard-Karls-Universitat, Berufsgenossenschaftliche Unfallklinik Tubingen.
FAU - Micheel, M
AU  - Micheel M
AD  - Klinik fur Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie an der 
      Eberhard-Karls-Universitat, Berufsgenossenschaftliche Unfallklinik Tubingen.
FAU - Gonser, P
AU  - Gonser P
AD  - Klinik fur Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie an der 
      Eberhard-Karls-Universitat, Berufsgenossenschaftliche Unfallklinik Tubingen.
FAU - Schaller, H-E
AU  - Schaller HE
AD  - Klinik fur Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie an der 
      Eberhard-Karls-Universitat, Berufsgenossenschaftliche Unfallklinik Tubingen.
FAU - Rothenberger, J
AU  - Rothenberger J
AD  - Klinik fur Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie an der 
      Eberhard-Karls-Universitat, Berufsgenossenschaftliche Unfallklinik Tubingen.
LA  - ger
PT  - Journal Article
TT  - Analyse von Fallpauschalen und deren versorgungsrelevante Effekte in der 
      postbariatrischen Wiederherstellungschirurgie.
DEP - 20160822
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  - *Bariatric Surgery
MH  - Costs and Cost Analysis
MH  - *Diagnosis-Related Groups
MH  - Germany
MH  - Hospitals, University
MH  - Humans
MH  - *Weight Loss
EDAT- 2016/08/23 06:00
MHDA- 2018/04/12 06:00
CRDT- 2016/08/23 06:00
PHST- 2016/08/23 06:00 [entrez]
PHST- 2016/08/23 06:00 [pubmed]
PHST- 2018/04/12 06:00 [medline]
AID - 10.1055/s-0042-110568 [doi]
PST - ppublish
SO  - Handchir Mikrochir Plast Chir. 2016 Aug;48(4):226-32. doi: 10.1055/s-0042-110568. 
      Epub 2016 Aug 22.