[The Cost of Lipoedema Treatment Exceeds the DRG Revenues - Evaluation of the Surgical Treatment Costs of Lipoedema (Stage III) at a German University Clinic].

IF 0.4 4区 医学 Q4 SURGERY Handchirurgie Mikrochirurgie Plastische Chirurgie Pub Date : 2024-09-16 DOI:10.1055/a-2362-1185
Philipp Moog, Edith Gawlik, Stefan Eisenreich, Oliver Schoeffski, Hans-Günther Machens, Jun Jiang, Haydar Kükrek
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Abstract

Background: Liposuction for stage III lipoedema is a guideline-based but also time-consuming treatment, which can be carried out under specific conditions at the expense of the German statutory health insurance companies (SHI) based on a decision made by the German Federal Joint Committee ("Gemeinsamer Bundesausschuss", G-BA), the highest decision-making body in the German healthcare system, in 09/2019. We postulate that the treatment is not reflected in a cost-covering manner in the university cost system.

Methods: This monocentric, retrospective study examined the economic aspects of 92 cases in 48 lipoedema patients treated during the period from 09/2019 to 08/2023 at the expense of the SHI. These cases were filtered out using DRG coding and the Operation and Procedure Classification system ("Operationen- und Prozedurenschlüssel", OPS), and the costs and revenues per patient were calculated using the data from our internal service accounting.

Results: After an inpatient stay of 2.64±1.33 days, the total revenue was € 4,726.79±680.98. This included € 1,532.92±856.99 inpatient costs, € 2,686.02±1,174.70 in operating costs, € 940.76±189.18 in anaesthesia costs and € 63.19±125.38 in other costs that had to be paid within the clinic. On average across all treatments, this resulted in a loss of -€ 875.22 /case. In 54 cases (59%), the costs exceeded the revenue. In total, the calculation of all cases resulted in a loss of € -80,520.63. If medical personnel costs are included, this amount rises to over € 100,000.

Conclusion: The results show that the surgical treatment of lipoedema in the German DRG and university cost systems is not cost-covering. This could be relevant in the final economic assessment of the G-BA, which may result in an adjustment of the DRG revenue.

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[脂肪性水肿治疗费用超过 DRG 收入--德国一所大学诊所脂肪性水肿(III 期)手术治疗费用评估]。
背景:根据德国联邦联合委员会("Gemeinsamer Bundesausschuss",G-BA)--德国医疗系统的最高决策机构--于2019年9月做出的决定,在特定条件下可由德国法定医疗保险公司(SHI)承担费用。我们推测,在大学成本系统中,该治疗方法并未以成本覆盖的方式反映出来:这项单中心回顾性研究对 2019 年 9 月至 2023 年 8 月期间由社会保险局出资治疗的 48 名脂肪性水肿患者中的 92 个病例进行了经济方面的调查。这些病例是通过 DRG 编码和手术及程序分类系统("Operationen- und Prozedurenschlüssel",OPS)筛选出来的,每位患者的成本和收入是通过我们的内部服务会计数据计算出来的:住院时间为 2.64±1.33 天,总收入为 4,726.79±680.98 欧元。其中包括住院费用 1,532.92±856.99 欧元、手术费用 2,686.02±1,174.70 欧元、麻醉费用 940.76±189.18 欧元以及必须在诊所内支付的其他费用 63.19±125.38 欧元。所有治疗的平均损失为-875.22 欧元/例。在 54 个病例(59%)中,成本超过了收入。计算所有病例的总损失为-80,520.63 欧元。如果将医务人员的费用计算在内,这一数额将超过 100 000 欧元:研究结果表明,在德国 DRG 和大学费用系统中,脂肪性水肿的手术治疗并不能覆盖成本。这可能与 G-BA 的最终经济评估有关,可能导致 DRG 收入的调整。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.00
自引率
16.70%
发文量
85
审稿时长
6-12 weeks
期刊介绍: In Originalarbeiten und Fallberichten finden Sie die neuesten Informationen über: Diagnostik Verfahrenswahl state of the art / neueste Techniken rekonstruktive Verfahren Behandlung infolge von Traumata oder OP Bewertung der Ergebnisse Klinische Forschung Interessante Darstellung der neuesten Erkenntnisse in Originalarbeiten und Fallberichten. Exzellent veranschaulicht durch ein klares Layout und reiche Bebilderung. Überzeugen Sie sich selbst! Organschaften Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie, Deutschen Gesellschaft für Handchirurgie und Österreichischen Gesellschaft für Handchirurgie Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der peripheren Nerven und Gefäße Organ der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen
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