Hierl, Katja and Rupp, Markus and Worlicek, Michael and Baumann, Florian and Pfeifer, Christian and Alt, Volker (2021) 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. ORTHOPADE, 50 (9). pp. 728-741. ISSN 0085-4530, 1433-0431
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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.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ; Diagnosis Related Group; Hospitals; Length of stay; Revision surgery; Staphylococcal infections |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Unfallchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 29 Aug 2022 07:27 |
| Last Modified: | 29 Aug 2022 07:27 |
| URI: | https://pred.uni-regensburg.de/id/eprint/46398 |
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