Auswirkungen des Pflegepersonalstärkungsgesetzes auf die minimal-invasive Chirurgie am Beispiel der Hemikolektomie rechts aus ökonomischer Perspektive View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-10-27

AUTHORS

Raphael Winkels, Stefan Schad, Oliver Schöffski, Matthias H. Seelig

ABSTRACT

BackgroundIn the past, a reduced length of postoperative hospital stay was considered a sufficient trade-off to refinance the additional costs associated with minimally invasive surgery; however, with the implementation of the Nursing Personnel Strengthening Act and disincorporation of nursing costs, this argumentation needs to be fundamentally reevaluated.MethodUsing right-sided hemicolectomy as an example, a retrospective case analysis was conducted. Cost reductions associated with the length of hospital stay were compared before and after the introduction of the revised German diagnosis-related groups (aG-DRG) and offset against the increased material and personnel costs.ResultsAmong the analyzed cases, the utilization of minimally invasive surgical techniques led to a substantial cost reduction per case compared to conventional surgical treatment. After the introduction of the aG-DRGs the financial benefits of a shortened hospital stay are greatly diminished and cannot be used to refinance the expenses necessary to perform minimally invasive surgery. From a strictly economical perspective, there is a strong incentive to only perform open surgical procedures.ConclusionDisincorporation of nursing costs has destabilized the fragile concept of indirect refinancing of advanced operative techniques by the financial incentives associated with a shorter hospital stay. In order to comply with statutory regulations to implicate a performance-based funding, there is an urgent necessity to adjust the grouping algorithms for minimally invasive surgical procedures to the corresponding flat rates. More... »

PAGES

490-498

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00104-021-01523-5

DOI

http://dx.doi.org/10.1007/s00104-021-01523-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1142205830

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/34705055


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