PMID- 32877947
OWN - NLM
STAT- MEDLINE
DCOM- 20201210
LR  - 20221207
IS  - 1439-3980 (Electronic)
IS  - 0722-1819 (Linking)
VI  - 52
IP  - 6
DP  - 2020 Dec
TI  - [Economic aspects of interdisciplinary plastic surgery: change in 
      Diagnosis-Related Groups (DRG) due to procedures of reconstructive microsurgery].
PG  - 464-472
LID - 10.1055/a-1230-3914 [doi]
AB  - BACKGROUND:  Advances in reconstructive microsurgery have led to significant 
      improvements in the surgical care of complex interdisciplinary cases. At the same 
      time, however, this also increases the resource expenditure of the plastic 
      surgeon involved. This study aimed to analyse the relationship between increase 
      in revenue and resource expenditure in reconstructive microsurgery at a 
      university hospital of maximum care with regard to the treatment of 
      interdisciplinary patients. METHODS:  In 2018 and 2019, all cases of 
      interdisciplinary cooperation were followed up at one location of a plastic 
      surgery department of a university clinic. The interdisciplinary surgical cases 
      were identified from the collective and evaluated prospectively with regard to 
      inpatient treatment days, surgical resource expenditure and economic development 
      (DRG before and after microsurgical reconstruction). RESULTS:  In 2018 and 2019, 
      a total of 68 free microsurgical flaps were performed in 64 interdisciplinary 
      cases. 62 of these cases met the criteria for interdisciplinary surgical 
      treatment. Considering the contribution of plastic surgery to the economic 
      development and the associated resource expenditure, there is a significant 
      increase in all parameters (p < 0.0001). Thus, the Case Mix Index (CMI) rose by 
      20.2 %, inpatient treatment days by 79.1 %, the number of surgical interventions 
      by 62.4 %, cumulative incision-suture time by 131.4 % and total surgeon hours by 
      75.4 %. CONCLUSION:  Reconstructive microsurgical procedures lead to a 
      significant increase in revenue in interdisciplinary surgical cases. However, a 
      significant increase in resource consumption is observed as well. Moreover, these 
      additional costs are not always adequately reflected in the revenue of the DRG. 
      This especially applies to DRGs with a high initial cost weight. To ensure 
      modern, individual, patient-oriented and guideline-compliant patient care, there 
      is, therefore, an urgent need to adapt the (G-)DRG system to the additional 
      resource consumption. In addition, in the case of interdisciplinary surgical 
      cases, a clear internal cost allocation must be carried out in accordance with 
      the surgical resource expenditure.
CI  - (c) Georg Thieme Verlag KG Stuttgart . New York.
FAU - Wachtel, Nikolaus
AU  - Wachtel N
AUID- ORCID: 0000-0003-3746-7838
AD  - Abteilung fur Hand-, Plastische und Asthetische Chirurgie, Klinikum der 
      Universitat Munchen, LMU Munchen.
FAU - Wiggenhauser, Paul S
AU  - Wiggenhauser PS
AD  - Abteilung fur Hand-, Plastische und Asthetische Chirurgie, Klinikum der 
      Universitat Munchen, LMU Munchen.
FAU - Ahmad, Nura
AU  - Ahmad N
AD  - Abteilung fur Hand-, Plastische und Asthetische Chirurgie, Klinikum der 
      Universitat Munchen, LMU Munchen.
FAU - Giunta, Riccardo E
AU  - Giunta RE
AD  - Abteilung fur Hand-, Plastische und Asthetische Chirurgie, Klinikum der 
      Universitat Munchen, LMU Munchen.
FAU - Ehrl, Denis
AU  - Ehrl D
AD  - Abteilung fur Hand-, Plastische und Asthetische Chirurgie, Klinikum der 
      Universitat Munchen, LMU Munchen.
LA  - ger
PT  - Journal Article
TT  - Okonomische Aspekte der interdisziplinaren Plastischen Chirurgie - Veranderung 
      der diagnosebezogenen Fallgruppen (DRG) durch Eingriffe der rekonstruktiven 
      Mikrochirurgie.
DEP - 20200902
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  - Diagnosis-Related Groups
MH  - *Free Tissue Flaps
MH  - Humans
MH  - Microsurgery
MH  - *Plastic Surgery Procedures
MH  - *Surgery, Plastic
COIS- Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.
EDAT- 2020/09/03 06:00
MHDA- 2020/12/15 06:00
CRDT- 2020/09/03 06:00
PHST- 2020/09/03 06:00 [pubmed]
PHST- 2020/12/15 06:00 [medline]
PHST- 2020/09/03 06:00 [entrez]
AID - 10.1055/a-1230-3914 [doi]
PST - ppublish
SO  - Handchir Mikrochir Plast Chir. 2020 Dec;52(6):464-472. doi: 10.1055/a-1230-3914. 
      Epub 2020 Sep 2.