Betriebswirtschaftliche Auswirkungen der thorakalen Epiduralanästhesie bei urologischen Operationen: Dargestellt am Beispiel der G-DRG M01B, OPS-301 5–604.0 (radikale retropubische Prostatektomie)

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • A. R. Heller - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Anästhesiologie und Intensivtherapie (Autor:in)
  • R. J. Litz - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Anästhesiologie und Intensivtherapie (Autor:in)
  • D. Wießner - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Urologie (Autor:in)
  • C. Dammann - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Anästhesiologie und Intensivtherapie (Autor:in)
  • R. Weissgerber - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Anästhesiologie und Intensivtherapie (Autor:in)
  • O. W. Hakenberg - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Urologie (Autor:in)
  • M. P. Wirth - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Urologie (Autor:in)
  • T. Koch - , Klinik und Poliklinik für Anaesthesiologie und Intensivtherapie, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)

Abstract

Introduction. Using the surgical procedure OPS 5-604.0 (radical retropubic prostatectomy) as an example, our study identifies revenue-relevant patient characteristics and describes the impact of the perioperative application of thoracic epidural analgesia (TEA). Methods. Factors affecting duration of stay were determined in 460 patients undergoing OPS 5-604.0 in the year 2001 and 2002 using multifactorial regression analysis. Preoperative parameters served as factors for matched-pair analysis of the effects of TEA. Results. Characteristics significantly affecting length of postoperative hospital stay were ASA status, age, preoperative haemoglobin concentration, postoperative tachycardia, number of transfused packed red cells, wound infection and surgical revision. Based on identical matching criteria 27 pairs (with/without TEA) could be formed. While the induction time in the TEA group was 8±18 min longer (p=0.04), emergence was briefer by 3±9 min (p=0.045). Neither anaesthesia presence time nor anaesthesia costs or total costs of surgery differed significantly between the pairs. However, duration of epidural postoperative pain therapy was longer with TEA but in contrast, the postoperative length of hospital stay after TEA was reduced. Assuming a continuous demand for OPS 5-604.0 procedures, TEA enables 32 more procedures to be carried out per year with an increased yield on turnover of 2.7%. Conclusion. At first sight combined anaesthesia procedures require more human resources and material, however, as a result of shortened hospital stay and optimized pain therapy patient satisfaction increases and a substantial potential for increased revenue is gained.

Details

OriginalspracheDeutsch
Seiten (von - bis)1176-1185
Seitenumfang10
FachzeitschriftAnaesthesist
Jahrgang54
Ausgabenummer12
PublikationsstatusVeröffentlicht - Dez. 2005
Peer-Review-StatusJa

Externe IDs

PubMed 16034637

Schlagworte

Schlagwörter

  • Clinical pathway, Length of hospital stay, Matched-pair analysis, Process adjustment, Radical prostatectomy, Thoracic epidural analgesia