title: [Outlier cases in surgical disciplines. Micro-economic and macro-economic problems].
abstract: Postoperative complications will always occur and the negative impact puts strain on patients, relatives and the attending physicians. The conversion to a remuneration system based on flat rates (diagnosis-related groups) presents additional economic problems for hospitals in some resource-intensive treatments. This particularly pertains to extremely cost-intensive cases in which costs succeed revenue by the factor of 2 and are often surgical procedures. Here the economic risk increases with the number of interventions performed. Despite improvements in the remuneration system this problem persists. An improved payment for these treatments is desirable. To achieve this it is necessary to systematically analyze the extremely cost-intensive cases by experts of different medical disciplines to create a data basis for a proposal of a cost-covering payment.
authors.affiliation: Medizinische Hochschule Hannover, OE 1110, Carl-Neuberg-Str. 1, 30625, Hannover. Tecklenburg.Andreas@mh-hannover.de
authors.forename: A
authors.initials: A
authors.lastname: Tecklenburg
authors.forename: J
authors.initials: J
authors.lastname: Liebeneiner
authors.forename: O
authors.initials: O
authors.lastname: Schaefer
mesh_terms: D005858:Germany; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics; D009313:National Health Programs / Q000191:economics*; D016311:Outliers, DRG / Q000191:economics*; D010348:Patient Care Team / Q000191:economics; D011182:Postoperative Care / Q000191:economics; D011183:Postoperative Complications / Q000191:economics* / Q000601:surgery; D012051:Reimbursement Mechanisms / Q000191:economics; D020444:Reimbursement, Disproportionate Share / Q000191:economics; D015895:Relative Value Scales; D012086:Reoperation / Q000191:economics