[Implementation of a department of plastic surgery in a university clinic for trauma surgery].
BACKGROUND
Since May 2012 plastic surgery for trauma patients at the University Hospital Leipzig is provided by an autonomous department.


OBJECTIVE
This study analyzed the effect of plastic surgery on the changes in diagnosis-related groups (DRG) at a clinic for trauma surgery.


METHODS
Within the first 2 years 37 patients (29 male and 8 female of which 38 were inpatient cases) were admitted to the clinic for trauma surgery and additionally received plastic surgery treatment. The appropriate DRG assignment as well as associated codes and revenues were recorded and compared with and without plastic surgery.


RESULTS
A total of 261 operations were performed on these patients of which 71 were performed by the department of plastic surgery. The mean revenue was 22,156.44 EUR±20,578.22 EUR with a mean cost weighting of 7.2±6.7. Excluding plastic surgery treatment the mean revenue was 19,378.44 EUR±20,688.40 EUR and the mean cost weighting was 6.3±6.7. Thus, additional proceeds by the plastic surgery treatment were 2778.00 EUR±3857.01 EUR per case. The mean increase of the cost weighting was 0.9±1.3. A change of the DRG grouping occurred in 20 out of 38 cases treated. The mean length of stay (LoS) was 40.2±26.6 days. In the first year this was 17.9±22.4 days more than the mean national LoS of the appropriate DRG and 10.9±19.3 days in the second year. This means an average cost reduction of 4774.59 EUR per case.


CONCLUSIONS
The implementation of a department for plastic surgery increased the revenues. Additional profits should be achieved by process enhancement and not by prolonged LoS.
Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig AöR, Liebigstr. 20, 04103, Leipzig, Deutschland, nikolaus.vondercks@medizin.uni-leipzig.de.
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von Dercks
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Fakler
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Langer
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Josten
D000328:Adult; D000368:Aged; D003953:Diagnosis-Related Groups / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000191:economics*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000191:economics*; D013333:Student Health Services / Q000191:economics*; D013518:Surgery, Plastic / Q000191:economics*; D014194:Traumatology / Q000191:economics*; D055815:Young Adult