Vergleich der DRG-Erlöse zwischen Fast- und Slow-Track-Verfahren beim zweizeitigen Prothesenwechsel bei periprothetischen Hüftinfektionen im aG-DRG-System 2020

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 w...

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Detalles Bibliográficos
Autores principales: Hierl, Katja, Rupp, Markus, Worlicek, Michael, Baumann, Florian, Pfeifer, Christian, Alt, Volker
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Medizin 2021
Materias:
Originalien
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058599/
https://www.ncbi.nlm.nih.gov/pubmed/33881565
http://dx.doi.org/10.1007/s00132-021-04106-8
Descripción
Sumario: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 € and for a length of stay of 42 days (with SD) even 40,699 €, compared to 23,965 € with the fast-track procedure with a length of stay of 25 days (without SD) and 27,283 € 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 € 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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