PMID- 31863425
OWN - NLM
STAT- MEDLINE
DCOM- 20200604
LR  - 20220414
IS  - 1439-7803 (Electronic)
IS  - 0044-2771 (Linking)
VI  - 58
IP  - 4
DP  - 2020 Apr
TI  - [Prognostic significance and economic burden of hepatic encephalopathy in liver 
      cirrhosis in German hospitals based on G-DRG data].
PG  - 323-331
LID - 10.1055/a-1068-3138 [doi]
AB  - INTRODUCTION:  Hepatic encephalopathy (HE) represents a frequent complication of 
      liver cirrhosis with negative effects on patients' lives. The prevalence of 
      clinical HE is estimated to be between 30-45 %. Regardless of its clinical and 
      prognostic relevance HE is considered to be underdiagnosed. METHODS:  Beyond a 
      systematic analysis of mortality of HE, we investigated the economic impact and 
      reimbursement situation for HE in patients with liver cirrhosis in Germany. For 
      the retrospective analysis, anonymized data (2011-2015) concerning expenses and 
      diagnoses ( section sign 21-4 KHEntgG) were obtained from 74 participating hospitals of the 
      Diagnosis Related Groups (DRG) Project of the German Gastroenterological 
      Association (DGVS). Furthermore, results were compared with case data from all 
      German hospitals provided by the German Federal Authority on Statistics 
      (Statistische Bundesamt (Destatis), Wiesbaden). RESULTS:  In participating 
      hospitals 59 093 cases with liver cirrhosis were identified of which 14.6 % were 
      coded as having HE. Hospital mortality was threefold increased compared to 
      cirrhosis-patients without HE (20.9 versus 7.5 %). Cases with cirrhosis as well 
      as the proportion with HE increased over time. Compared to all patients with 
      cirrhosis, reimbursement for HE patients produced a deficit (of up to 634 euro for 
      HE grade 4). DISCUSSION:  Mortality is threefold increased in patients with 
      cirrhosis when an additional HE is diagnosed. Hospitals participating in the 
      DGVS-DRG-project coded 2 % more HE cases among their cirrhosis cases than the 
      rest of hospitals either because of a selection bias for greater disease severity 
      or because of better coding quality. At present, reimbursement for HE patients on 
      the basis of F-DRG-system produced a deficit.
CI  - (c) Georg Thieme Verlag KG Stuttgart . New York.
FAU - Gundling, Felix
AU  - Gundling F
AD  - Klinik fur Gastroenterologie, Hepatologie und Gastroenterologische Onkologie, 
      Klinikum Bogenhausen, Stadtisches Klinikum Munchen GmbH.
FAU - Rathmayer, Markus
AU  - Rathmayer M
AD  - inspiring health GmbH, Munchen.
FAU - Koller, Lisa
AU  - Koller L
AD  - inspiring health GmbH, Munchen.
FAU - Wilke, Michael
AU  - Wilke M
AD  - inspiring health GmbH, Munchen.
FAU - Kircheis, Gerald
AU  - Kircheis G
AD  - Klinik fur Allgemeine Innere Medizin, Gastroenterologie, Diabetologie, 
      Hepatologie (Lebererkrankungen) und Stoffwechselerkrankungen, 
      Universitatsklinikum Brandenburg an der Havel.
FAU - Wedemeyer, Heiner
AU  - Wedemeyer H
AD  - Klinik fur Gastroenterologie und Hepatologie, Universitatsklinikum Essen.
FAU - Labenz, Joachim
AU  - Labenz J
AD  - Abteilung Innere Medizin I mit Schwerpunkt Gastroenterologie, 
      Robert-Bosch-Krankenhaus, Stuttgart.
FAU - Albert, Jorg
AU  - Albert J
AD  - Fachabteilung Innere Medizin, Diakonie Klinikum Jung-Stilling, Siegen.
FAU - Schepp, Wolfgang
AU  - Schepp W
AD  - Klinik fur Gastroenterologie, Hepatologie und Gastroenterologische Onkologie, 
      Klinikum Bogenhausen, Stadtisches Klinikum Munchen GmbH.
FAU - Lerch, Markus M
AU  - Lerch MM
AD  - Klinik und Poliklinik fur Innere Medizin A, Universitatsklinikum Greifswald.
AD  - DRG-Projektgruppe der Deutsche Gesellschaft fur Gastroenterologie, Verdauungs- 
      und Stoffwechselkrankheiten (DGVS).
CN  - fur die DRG-Projektgruppe der DGVS
LA  - ger
PT  - Journal Article
TT  - Mortalitat und okonomische Auswirkungen der hepatischen Enzephalopathie bei 
      Leberzirrhose in deutschen Krankenhausern auf der Basis von G-DRG-Kostendaten.
DEP - 20191220
PL  - Germany
TA  - Z Gastroenterol
JT  - Zeitschrift fur Gastroenterologie
JID - 0033370
SB  - IM
MH  - *Cost of Illness
MH  - Diagnosis-Related Groups
MH  - Germany
MH  - Hepatic Encephalopathy/*economics/mortality/therapy
MH  - Hospital Costs
MH  - Humans
MH  - Liver Cirrhosis/*economics/mortality/therapy
MH  - Prognosis
MH  - Retrospective Studies
COIS- M. Rathmayer, L. Koller und M. Wilke haben fur die Analyse ein Beratungshonorar 
      von der Fa. Norgine GmbH, Marburg erhalten. Gundling F., Labenz J. und Wedemeyer 
      J. haben fur Vortrags- und Beratungstatigkeit in der Vergangenheit Honorare von 
      Norgine erhalten.
EDAT- 2019/12/22 06:00
MHDA- 2020/06/05 06:00
CRDT- 2019/12/22 06:00
PHST- 2019/12/22 06:00 [pubmed]
PHST- 2020/06/05 06:00 [medline]
PHST- 2019/12/22 06:00 [entrez]
AID - 10.1055/a-1068-3138 [doi]
PST - ppublish
SO  - Z Gastroenterol. 2020 Apr;58(4):323-331. doi: 10.1055/a-1068-3138. Epub 2019 Dec 
      20.