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Vergleich der DRG-Erlöse zwischen Fast- und Slow-Track-Verfahren beim zweizeitigen Prothesenwechsel bei periprothetischen Hüftinfektionen im aG-DRG-System 2020
Comparison of DRG revenues between fast and slow-track procedures for a two-stage replacement of prostheses for periprosthetic hip infections in the aG-DRG system 2020
Hierl, Katja, Rupp, Markus
, Worlicek, Michael, Baumann, Florian
, Pfeifer, Christian and Alt, Volker
(2021)
Vergleich der DRG-Erlöse zwischen Fast- und Slow-Track-Verfahren beim zweizeitigen Prothesenwechsel bei periprothetischen Hüftinfektionen im aG-DRG-System 2020
Comparison of DRG revenues between fast and slow-track procedures for a two-stage replacement of prostheses for periprosthetic hip infections in the aG-DRG system 2020. Der Orthopäde 50, pp. 728-741.
Date of publication of this fulltext: 28 Apr 2021 05:08
Article
DOI to cite this document: 10.5283/epub.45585
Abstract
Background The treatment of periprosthetic hip infections is usually cost intensive, so it is generally not cost effective for hospitals. In chronic infections, a two-stage procedure is often indicated, which can be done as a fast-track procedure with a short prosthetic-free interim interval (2-4 weeks) or as a slow-track procedure with a long prosthetic-free interim interval (over 4 weeks). Aim ...
Background The treatment of periprosthetic hip infections is usually cost intensive, so it is generally not cost effective for hospitals. In chronic infections, a two-stage procedure is often indicated, which can be done as a fast-track procedure with a short prosthetic-free interim interval (2-4 weeks) or as a slow-track procedure with a long prosthetic-free interim interval (over 4 weeks). Aim The aim of this study was to elucidate the revenue situation of both forms of treatment in the aG-DRG-System 2020, taking into account revenue-relevant influencing factors. Methods For fast-track and slow-track procedures with two-stage revision and detection of a staphylococcus aureus (MSSA), treatment cases were simulated using a grouper software (3M KODIP Suite) based on the diagnoses (ICD-10-GM) and procedures (OPS) and then grouped into DRGs. Revenue-relevant parameters, such as length of stay and secondary diagnoses (SD), were taken into account. In addition, two real treatment cases with fast-track and slow-track procedures were compared to each other. Results The total revenues for the slow-track procedure with a length of stay of 25 days (without SD) were 27,551 euro and for a length of stay of 42 days (with SD) even 40,699 euro, compared to 23,965 euro with the fast-track procedure with a length of stay of 25 days (without SD) and 27,283 euro for a length of stay of 42 days (with SD). The real treatment cases also showed a big difference in the total revenues of 12,244 euro in favor of the slow-track procedure. Discussion Even in the aG-DRG-System 2020, the two-stage revision procedure with a long interim interval seems to be more interesting from a financial point of view and the hospital perspective compared to the fast-track procedure, especially with multimorbid patients. This creates a financial barrier to the treatment of such patients with a short interim interval.
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| Item type | Article | ||||
| Journal or Publication Title | Der Orthopäde | ||||
| Publisher: | Springer | ||||
|---|---|---|---|---|---|
| Open Access Type: | DEAL (Springer) | ||||
| Place of Publication: | NEW YORK | ||||
| Volume: | 50 | ||||
| Page Range: | pp. 728-741 | ||||
| Date | 21 April 2021 | ||||
| Institutions | Medicine > Lehrstuhl für Unfallchirurgie | ||||
| Identification Number |
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| Keywords | ; Diagnosis Related Group; Hospitals; Length of stay; Revision surgery; Staphylococcal infections | ||||
| Dewey Decimal Classification | 600 Technology > 610 Medical sciences Medicine | ||||
| Status | Published | ||||
| Refereed | Yes, this version has been refereed | ||||
| Created at the University of Regensburg | Yes | ||||
| URN of the UB Regensburg | urn:nbn:de:bvb:355-epub-455851 | ||||
| Item ID | 45585 |
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