Teilzementierte und unzementierte Hüftendoprothetik

Hanstein, Tim; Kumpe, O.; Mittelmeier, Wolfram; Skripitz, Ralf

doi:10.1007/s00132-015-3139-3

Cited by 6 publications

(9 citation statements)

References 17 publications

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“…Numerous regulatory interventions and binding obligations are increasingly narrowing hospitals’ scope of action. Consequently, contribution margins must be increasingly analyzed and differentiated by individual service areas, and additional insights derived from the analysis must be implemented in hospital management [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…For senior physicians (“Kaderärzte”), this means assuming responsibility for their departments’ cost structure and revenues in addition to clinical, personnel, and continuing educational duties [ 21 ]. The annually changing dynamic SwissDRG reimbursement systems, as well as highly standardized procedures, at annually decreasing cost weights of high-profit procedures and thus decreasing reimbursement contributions additionally limit the opportunity to increase revenues [ 20 ]. Thus, since the revision of the KVG and the introduction of SwissDRG in 2012, there has been an increasing pressure for more economical service provisions and a need for an increase in the number of cases in strategically important areas, as was already the case in Germany [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…To achieve the required profit and the above-mentioned EBITDA margin of preferably over 10% while maintaining the service mission assigned to Swiss hospitals, the comprehensive control and monitoring of the clinics’ cost and revenue structures is indispensable [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Analysis of Factors Relevant to Revenue Enhancement in Hernia Interventions (SwissDRG G09)

et al. 2021

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Background: Since diagnosis-related groups (SwissDRG) were established in Switzerland in 2012, small and medium-size hospitals have encountered increasing financial troubles. Even though hernia repair operations are frequent, most hospitals fail to cover their costs with these procedures. Previous studies have focused mainly on analyzing costs and the contributing factors but less on variables that can be positively influenced. Therefore, this study aims to identify the relevant and influenceable factors for revenue growth in hernia repair surgery. Methods: Data from all patients who underwent the SwissDRG G09 surgery for a hernia in 2019 were analyzed. The contribution margin (CM4), as well as any over- or under-coverage, was correlated to case-specific costs. Results: A total of 168 patients received hernia repair surgery with the SwissDRG code G09. The average revenue/loss generated by one procedure was CHF −623.84. Procedures covered by the General Health Insurance (OKP) generated a loss of CHF −830.70 on average, whereas procedures covered by private insurance companies (VVG) generated revenue of CHF +1100 on average. Significant factors impacting the profitability of hernia repair operations were teaching during surgery (p < 0.005), the surgical operating time (p < 0.001), the total anesthesia time (p < 0.001), the number of surgeons present (p = 0.022), the insurance state of patients (p < 0.001), and the type of surgery (p < 0.01 for Lichtenstein’s procedure). Conclusions: This study reveals that hernia repair surgery performed under cost coverage by OKP is generally unprofitable. Our results further imply that the most important and influenceable factors for revenue enhancement are the quality and process optimization of the surgical department. To compensate for this deficit, hospitals should aim to increase the percentage of patients with private health insurance coverage in their procedures. Since outpatient surgery does not provide a valid alternative due to the low reimbursement by insurance companies, the cost efficiency of inpatient hernia repair needs to be increased by process optimization of the surgical department; for instance, by providing specialized hernia teams performing with shorter operation times and high quality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Analysis of Factors Relevant to Revenue Enhancement in Hernia Interventions (SwissDRG G09)

et al. 2021

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“…Например, R. Fernández-Fernández с соавторами отмечают, что с внедрением системы "lump sum reimbursements" выросло число госпитальных контроллеров, которые посчитывают стоимость операции, ухода, диагностики [2]. При этом на самом деле принцип «сколько потратили, столико и оплатим» не всегда работает до своего финального девиза: если лечение пациента оказалось дешевле среднего, то больница становится более маржинальной, а если дороже -то часто такой пациент так и остается убыточным для больницы без соответствующей компенсации [3].…”

Section: общие вопросы экономикиunclassified

Economics of Total Hip Arthroplasty: Review

Середа

Shubnyakov²,

Джавадов³

et al. 2022

Traumatology and Orthopedics of Russia

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This review article focuses on issues of economic analysis in providing care to patients requiring total hip arthroplasty. A large number of factors affecting the final financial result force us to look at economic research in the field of arthroplasty with a certain degree of criticality. At the same time, the existing financing systems cannot fully take into account all the possible costs arising from total hip arthroplasty. For this reason, studies concerning revision total hip arthroplasty are of particular interest, where treatment costs can vary significantly depending on the etiology and complexity of the case. These differences are reflected in the works of authors from France, Germany and Great Britain, who compared the treatment costs of patients with septic and aseptic revisions. Very different data both between countries and within the same country well demonstrate the need for a critical approach to the results of cost-effectiveness studies, QALYs based on Markov and other models, as the quality of the original data can be highly variable and reproduce the error of the initially incorrect price structure.

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“…Total hip arthroplasty (THA) is one of the most frequent operations in Germany [1] and leads to direct annual costs of 1.6 thousand million € [2]. It is expected that the demand for THA will remain high, as the population is becoming older and this leads to an increased incidence of arthrosis [3].…”

Section: Introductionmentioning

confidence: 99%

Outcome of an “Enhanced Recovery” Program in Contemporary Total Hip Arthroplasty in Germany

et al. 2019

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Background An inpatient hospital stay of up to 10 days after total hip arthroplasty (THA) is still common in Germany, mostly followed by inpatient rehabilitation. Internationally already widespread concepts for enhanced recovery are increasingly gaining popularity in Germany. Objectives The presentation of content and results of a newly implemented enhanced recovery concept in THA. Materials and Methods In this single-center, prospective observational study of a consecutive patient collective of a single surgeon, between January 2016 and July 2016, 103 short-stem THA patients were enrolled and treated using a newly introduced enhanced recovery concept. After 6 weeks and 6 months clinical examination was performed regarding function, pain, satisfaction and possible complications. Results The goal of discharge on day 4 after operation was reached in 61.2% of the patients with a mean postoperative inpatient stay of 4.9 days. After 6 weeks and 6 months respectively, excellent clinical results were achieved with high patient satisfaction. The complication rate was found to be low. Mean hemoglobin concentration decreased by 2.1 g/dl. A fissure of the femur below the implant healed conservatively applying no weight bearing for a total of 6 weeks. A pulmonary embolism that occurred during rehabilitation was also successfully treated. After 6 months one case showed a bursitis trochanterica. Conclusions Inpatient length of stay can be reduced by enhanced recovery concepts without increasing the risks to patients. Thus, in Germany these concepts will be applied increasingly.

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Teilzementierte und unzementierte Hüftendoprothetik

Cited by 6 publications

References 17 publications

Analysis of Factors Relevant to Revenue Enhancement in Hernia Interventions (SwissDRG G09)

Analysis of Factors Relevant to Revenue Enhancement in Hernia Interventions (SwissDRG G09)

Economics of Total Hip Arthroplasty: Review

Outcome of an “Enhanced Recovery” Program in Contemporary Total Hip Arthroplasty in Germany

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