Universität zu Köln

Baltin, Christoph, Kron, Florian, Urbanski, Alexander, Zander, Thomas, Kron, Anna, Berlth, Felix ORCID: 0000-0002-3780-0728, Kleinert, Robert, Hallek, Michael, Hoelscher, Arnulf Heinrich and Chon, Seung-Hun ORCID: 0000-0002-8923-6428 (2019). The economic burden of endoscopic treatment for anastomotic leaks following oncological Ivor Lewis esophagectomy. PLoS One, 14 (8). SAN FRANCISCO: PUBLIC LIBRARY SCIENCE. ISSN 1932-6203

Full text not available from this repository.

Abstract

Background Complications after surgery for esophageal cancer are associated with significant resource utilization. The aim of this study was to analyze the economic burden of two frequently used endoscopic treatments for anastomotic leak management after esophageal surgery: Treatment with a Self-expanding Metal Stent (SEMS) and Endoscopic Vacuum Therapy (EVT). Materials and methods Between January 2012 and December 2016, we identified 60 German-Diagnosis Related Group (G-DRG) cases of patients who received a SEMS and / or EVT for esophageal anastomotic leaks. Direct costs per case were analyzed according to the Institute for Remuneration System in Hospitals (InEK) cost-accounting approach by comparing DRG payments on the case level, including all extra fees per DRG catalogue. Results In total, 60 DRG cases were identified. Of these, 15 patients were excluded because they received a combination of SEMS and EVT. Another 6 cases could not be included due to incomplete DRG data. Finally, N = 39 DRG cases were analyzed from a profit-center perspective. A further analysis of the most frequent DRG code-G03-including InEK cost accounting, revealed almost twice the deficit for the EVT group (N = 13 cases, (sic) - 9.282 per average case) compared to that for the SEMS group (N = 9 cases, (sic) - 5.156 per average case). Conclusion Endoscopic treatments with SEMS and EVT for anastomotic leaks following oncological Ivor Lewis esophagectomies are not cost-efficient for German hospitals. Due to longer hospitalization and insufficient reimbursements, EVT is twice as costly as SEMS treatment. An adequate DRG cost compensation is needed for SEMS and EVT.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Baltin, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Kron, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Urbanski, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Zander, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Kron, Anna UNSPECIFIED UNSPECIFIED UNSPECIFIED Berlth, Felix UNSPECIFIED orcid.org/0000-0002-3780-0728 UNSPECIFIED Kleinert, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Hallek, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, Arnulf Heinrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Chon, Seung-Hun UNSPECIFIED orcid.org/0000-0002-8923-6428 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-143848
DOI:	10.1371/journal.pone.0221406
Journal or Publication Title:	PLoS One
Volume:	14
Number:	8
Date:	2019
Publisher:	PUBLIC LIBRARY SCIENCE
Place of Publication:	SAN FRANCISCO
ISSN:	1932-6203
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GASTROENTEROLOGY; DIAGNOSIS; STENT Multiple languages Multidisciplinary Sciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14384