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

URN to cite this document:

urn:nbn:de:bvb:355-epub-455851 Copy

DOI to cite this document:

10.5283/epub.45585 Copy

Hierl, Katja ; Rupp, Markus ; Worlicek, Michael ; Baumann, Florian ; Pfeifer, Christian ; Alt, Volker

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Date of publication of this fulltext: 28 Apr 2021 05:08

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Details

Item type:	Article
Open Access Type:	DEAL (Springer)
Journal or Publication Title:	Der Orthopäde
Publisher:	Springer
Place of Publication:	NEW YORK
Volume:	50
Page Range:	pp. 728-741
Date:	21 April 2021
Institutions:	Medicine > Lehrstuhl für Unfallchirurgie
Identification Number:	Value Type 10.1007/s00132-021-04106-8 DOI
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
Item ID:	45585

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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 ...

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 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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Metadata last modified: 16 Jan 2025 15:00

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