Kosten-Erlös-Defizit der ambulanten Versorgung von Bagatellverletzungen in der Notaufnahme

BACKGROUND: Many patients with minor injuries hastily present in the emergency department and tie up resources and personnel there. OBJECTIVE: To establish the cost-revenue relationship of outpatient care of minor injuries in the traumatology emergency department. MATERIAL AND METHODS: The calculation was based on the uniformly billed emergency flat rates of the uniform assessment standard (EBM). Using the current collective bargaining agreements for physicians and nurses, per minute costs were calculated. The time required for treatment was determined on the basis of 100 reference patients with minor injuries. The case cost calculation with the respective resources was carried out with the operational controlling of the University Hospital Frankfurt. RESULTS: A total of 4088 patients with minor injuries who presented in 2019 were included. Most common reasons for presentation were contusions of the lower (31.9%; n = 1303) and upper extremities (16.6%; n = 677). A time expenditure of 166.7 min per day for the medical staff and 213.8 min per day for nursing staff was calculated. A total revenue of 29,384.31 € and total costs of 69,591.22 € were calculated. Thus, a revenue deficit of −40,206.91 € can be calculated for the year 2019. This corresponds to a monetary deficit of 9.84 € per patient. CONCLUSION: There is a shortage of the medical resource “personnel” to satisfactorily and economically manage the nowadays high volume of self-presenting pedestrian patients with minor injuries. The current remuneration of the treatment of minor injuries by the uniform assessment scale is insufficient for the hospital sector. GRAPHIC ABSTRACT: [Image: see text]