title: [Impact of thoracic epidural analgesia on revenue for G-DRG M01B, OPS-301 5-604.0 (radical retropubic prostatectomy)].
abstract: BACKGROUND
  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%.
  
  
  CONCLUSIONS
  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.
authors: Klinik und Poliklinik für Anaesthesiologie und Intensivtherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität, Dresden. axel.heller@mailbox.tu-dresden.de
authors: A R
authors: AR
authors: Heller
authors: R J
authors: RJ
authors: Litz
authors: D
authors: D
authors: Wiessner
authors: C
authors: C
authors: Dammann
authors: R
authors: R
authors: Weissgerber
authors: O W
authors: OW
authors: Hakenberg
authors: M P
authors: MP
authors: Wirth
authors: T
authors: T
authors: Koch
mesh_terms: D000367:Age Factors; D000368:Aged; D015360:Analgesia, Epidural / Q000191:economics* / Q000706:statistics & numerical data; D017707:Erythrocyte Transfusion; D005858:Germany / Q000453:epidemiology; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D011184:Postoperative Period; D011468:Prostatectomy / Q000191:economics* / Q000706:statistics & numerical data; D012044:Regression Analysis; D013610:Tachycardia / Q000503:physiopathology
chemical_list: D006454:Hemoglobins