[Is polytrauma treatment in deficit in the aG-DRG system?]

4区医学 Q2 Medicine Unfallchirurg Pub Date : 2022-04-01 Epub Date: 2021-06-08 DOI:10.1007/s00113-021-01015-5

Nikolas Schopow, Anja Botzon, Kristian Schneider, Carolin Fuchs, Christoph Josten, Nikolaus von Dercks, Johannes Fakler, Georg Osterhoff

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Abstract

Background: The interdisciplinary care of severely injured patients is staff and resource intensive. Since the introduction of the G‑DRG system in Germany in 2003, most studies have identified a financial deficit in the care of severely injured patients. The aim of this study was to analyze the effects of the new aG-DRG system introduced in 2020 on cost recovery in the treatment of severely injured patients. For the first time, the costs for organization, certification and documentation as well as the costs for non-seriously injured shock room patients were included.

Methods: All patients who were treated in the surgical shock room of the emergency department of the Leipzig University Hospital in 2017 were included. For the analysis, the cost model according to Pape et al. was extended by the module organization, documentation and certification and for the first time the costs for overtriaged patients were considered. A cost calculation was performed for the years 2017-2020 as well a comparison with the respective earnings.

Results: A total of 834 patients were treated in the shock room and 258 severely injured patients were divided into 3 groups: ISS 9-15 + ICU (n 72; ∅ ISS 11.9; costs per patient 14,715 €),ISS ≥ 16 (n 186; ∅ ISS 27.7; costs per patient 30,718 €) and DRG polytrauma (n 59; ∅ ISS 32.4; costs per patient 26,102 €).

Conclusion: Polytrauma care under the aG-DRG 2020 is in deficit. Overall, in 2020 a deficit of 5858 € per severely injured patient resulted.

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[在 aG-DRG 系统中，多重创伤治疗是否存在缺陷？］

背景：重伤患者的跨学科护理需要大量人力和资源。自 2003 年德国引入 G-DRG 系统以来，大多数研究都发现重伤患者的护理存在财务赤字。本研究旨在分析 2020 年引入的新 aG-DRG 系统对重伤患者治疗成本回收的影响。该研究首次纳入了组织、认证和记录方面的成本，以及休克室非重伤患者的成本：方法：纳入 2017 年在莱比锡大学医院急诊科外科休克室接受治疗的所有患者。为了进行分析，根据 Pape 等人的成本模型，对组织、文件和认证模块进行了扩展，并首次考虑了过度损伤患者的成本。对 2017-2020 年的成本进行了计算，并与相应的收益进行了比较：共有 834 名患者在休克室接受了治疗，258 名重伤患者被分为 3 组：ISS9-15+ICU（72人；∅ ISS 11.9；每名患者费用14715欧元）、ISS≥16（186人；∅ ISS 27.7；每名患者费用30718欧元）和DRGs多创伤（59人；∅ ISS 32.4；每名患者费用26102欧元）：结论：2020 年 aG-DRG 下的多发性创伤护理出现赤字。结论：2020 年 aG-DRG 下的多发性创伤护理出现赤字。总体而言，2020 年每位重伤患者的赤字为 5858 欧元。

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来源期刊

Unfallchirurg 医学-急救医学

CiteScore

1.50

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Der Unfallchirurg is an internationally recognised publication organ. The journal deals with all aspects of accident surgery and reconstruction surgery and serves the continuing medical education of surgeons and accident surgeons with own practices and those working in hospitals. Practically-oriented works provide an overview on selected topics and offer the reader a summary of current findings from all fields of accident surgery. Besides the imparting of relevant background knowledge, the focus is on the assessment of scientific findings under consideration of practical experience. The reader is given concrete recommendations for his/her practical work.