Rathmayer, Markus and Heinlein, Wolfgang and Wagner, Tobias and Lerch, Markus M. and Lammert, Frank and Dollhopf, Markus and Haag, Cornelie and Goelder, Stefan Karl and Kandulski, Arne and Schad, Moritz and Schmidt, Alexandra and Gundling, Felix and Wilke, Michael and Albert, Joerg G. (2023) Costs of potentially outpatient endoscopic procedures in cases with a 1-day hospital stay versus a longer stay. ZEITSCHRIFT FUR GASTROENTEROLOGIE, 61 (05). pp. 504-514. ISSN 0044-2771, 1439-7803
Full text not available from this repository. (Request a copy)Abstract
Introduction The transfer of patient care and medical interventions that was previously provided on an inpatient basis to outpatient settings is a stated goal of health politics. It is unclear to what extent costs of an endoscopic procedure and the disease severity depend on the duration of inpatient treatment. We therefore examined whether endoscopic services for cases with a one-day length of stay (VWD) are comparably expensive to cases with a longer VWD.Methods Outpatient services were selected from the DGVS service catalog. Day cases with exactly one such gastroenterological endoscopic (GAEN) service were compared with cases with VWD > 1 day regarding their patient clinical complexity levels (PCCL) and mean costs. Data from the DGVS-DRG project with 21-KHEntgG cost data from a total of 57 hospitals from 2018 and 2019 served as the basis. Endoscopic costs were taken from cost center group 8 of the InEK cost matrix and plausibility checked.Results A total of 122,514 cases with exactly one GAEN service were identified. Statistically equal costs were shown in 30 of 47 service groups. In 10 groups, the cost difference was not relevant (< 10%). Cost differences > 10% existed only for EGD with variceal therapy, insertion of a self-expanding prosthesis, dilatation/bougienage/exchange with PTC/PTCD in place, non-extensive ERCP, endoscopic ultrasound in the upper gastrointestinal tract, and colonoscopy with submucosal or full thickness resection, or foreign object removal. PCCL differed in all but one group.Conclusion Gastroenterology endoscopy services provided as part of inpatient care but potentially performable on an outpatient basis are predominantly equally expensive for day cases as for patients with a length of stay greater than one day. The disease severity is lower. Calculated 21-KHEntgG cost data thus form a reliable basis for the calculation of appropriate reimbursement for hospital services to be provided as outpatient services under the AOP in the future.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | GASTROENTEROLOGY; Ambulatory surgery (AOP); EBM; ambulatory reimbursement; Institute for Hospital Reimbursement; Cost Distribution; Diagnostic Related Groups; health economics |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Apr 2024 05:03 |
| Last Modified: | 09 Apr 2024 05:03 |
| URI: | https://pred.uni-regensburg.de/id/eprint/60617 |
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