title: [Can Topical Negative Pressure Therapy be Performed as a Cost-Effective General Surgery Procedure in the German DRG System?].
abstract: BACKGROUND
  Topical negative pressure therapy (TNPT) has been established for surgical wound therapy with different indications. Nevertheless, there is only sparse evidence regarding its therapeutic superiority or cost-effectiveness in the German DRG system (G-DRG). This study was designed to analyse the cost-effectiveness of TNPT in the G-DRG system with a focus on daily treatment costs and reimbursement in a general surgery care setting.
  
  
  METHODS
  In this retrospective study, we included 176 patients, who underwent TNPT between 2007 and 2011 for general surgery indications. Analysis of the cost-effectiveness involved 149 patients who underwent a simulation to calculate the reimbursement with or without TNPT by a virtual control group in which the TNP procedure was withdrawn for DRG calculation. This was followed by a calculation of costs for wound dressings and TNPT rent and material costs. Comparison between the "true" and the virtual group enabled calculation of the effective remaining surplus per case.
  
  
  RESULTS
  Total reimbursement by included TNPT cases was 2,323 ,70.04 €. Costs for wound dressings and TNPT rent were 102,669.20 €. In 41 cases there was a cost-effectiveness (27.5%) with 607,422.03 € with TNP treatment, while the control group without TNP generated revenues of 442,015.10 €. Costs for wound dressings and TNPT rent were 47,376.68 €. In the final account we could generate a cost-effectiveness of 6759 € in 5 years per 149 patients by TNPT. In 108 cases there was no cost-effectiveness (72.5%).
  
  
  CONCLUSIONS
  TNPT applied in a representative general surgery setting allows for wound therapy without a major financial burden. Based on the costs for wound dressings and TNPT rent, a primarily medically based decision when to use TNPT can be performed in a balanced product cost accounting. This study does not analyse the superiority of TNPT in wound care, so further prospective studies are required which focus on therapeutic superiority and cost-effectiveness.
authors.affiliation: Allgemein-, Viszeral-, Thorax- und Unfallchirurgie, Klinikum der Stadt Ludwigshafen am Rhein, Deutschland.
authors.forename: Z
authors.initials: Z
authors.lastname: Hirche
authors.affiliation: Klinik für Hand-, Plastische- und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, Berufsgenossenschaftliche Unfallklinik Ludwigshafen, Plastische und Handchirurgie an der Universität Heidelberg, Ludwigshafen am Rhein, Deutschland.
authors.forename: L
authors.initials: L
authors.lastname: Xiong
authors.affiliation: Klinik für Hand-, Plastische- und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, Berufsgenossenschaftliche Unfallklinik Ludwigshafen, Plastische und Handchirurgie an der Universität Heidelberg, Ludwigshafen am Rhein, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Hirche
authors.affiliation: Allgemein-, Viszeral-, Thorax- und Unfallchirurgie, Klinikum der Stadt Ludwigshafen am Rhein, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Willis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages / Q000191:economics; D003362:Cost-Benefit Analysis / Q000191:economics*; D003953:Diagnosis-Related Groups / Q000191:economics*; D005260:Female; D013502:General Surgery / Q000191:economics*; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D054843:Negative-Pressure Wound Therapy / Q000191:economics*; D012051:Reimbursement Mechanisms / Q000191:economics; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult