PSS53 - The Impact of the German Drg-System on Policy Decision Making in Ent

Abstract

The German diagnosis-related groups (G-DRG) have been introduced as a reimbursement system for in-patient care. The aim of this study was to report on clinic-based data available from the G-DRG browser regarding the impact of middle ear implantation as a basis for future health care decision making in ear, nose and throat medicine (ENT). Using a clinical algorithm, the unevaluated D23Z database from 2012 was analyzed to determine epidemiological characteristics of patients with different types of hearing losses and receiving middle ear implants (MEI). All ICD-10 Codes used for the diagnosis of conductive (CHL), mixed (MHL) or sensorineural hearing loss (SNHL) were extracted. The number of MEI cases reported in the D23Z was analyzed regarding Patient Clinical Complexity Level (PCCL), age, sex and duration of stay. The incidence of MEI candidates to the total number of ICD-10 codes and per indication were calculated. According to the D23Z, approximately 30`000 individuals admitted to ENT clinics were diagnosed with a hearing loss. About 38% suffered from CHL, 8% suffered from MHL and 48% suffered from SNHL. The proportion of patients who received a MEI per indication were respectively 0.8% for SNHL, 8% for MHL and 1% for CHL. Overall, about 466 (1%) patients received a MEI. 49.8% of them were men and 50.2% were women. Children aged as young as 1-2 years could also receive treatment. All patients had normal-term stay in hospitals with no comorbidities or complications (PCCL <4 in 99.2% of cases) The incidence of MEI to the ENT patient base and the German population were respectively 15.5/1,000 and 0.6/100,000. The overall number of middle ear implantations compared to standard treatments is quite low. Analyzing data on MEI available from highly-developed DRG systems can be used by other countries for policy decision making in ENT.