Wirtschaftliche Evaluation angiographischer Interventionen einschließlich einer radiologischen stationären und ambulanten Patientenbetreuung

Abstract

To determine the economic efficiency of a whole-radiology in- and outpatient treatment with angiographic interventions performed as the main or sole therapy. The calculations represent the data of a university radiology department, including the following angiographic interventions (neuroradiology not considered): Vascular intervention (PTA, stent implantation) of kidneys and extremities, recanalization of hemodialysis access, chemoembolization, diagnostic arterioportal liver CT, port implantation, varicocele embolization, PTCD, percutaneous implantation of biliary stent. First, the different angiographic interventions are categorized with reference to the German DRG system 2005. Considering the example of a university hospital, the individual cost of each intervention is calculated and correlated with reimbursements by G-DRG2005 and so-called "ambulant operation" (EBM200plus). With these data, profits and losses are calculated for both in- and outpatient care. Radiologic interventions of inpatients yield a profit in the majority of cases. With a base rate of 2900 euros, the profits in our university hospital range between - 872 euros and + 3411 euros (mean: + 1348 euros). On the other hand, those angiographic interventions suitable for "ambulant operation" generate average profits of + 372 euros, if only direct costs are considered. The data of outpatient radiological interventions average between 381 euros up to 1612 euros lower than compared with profits obtained from in patient care. Once an angiographic intervention represents the major or sole therapy, German radiologists are advised to operate out- and inpatient care by themselves. In Germany, the G-DRG-system and EBM enable radiology departments to generate considerable proceeds for their hospitals and, secondly, to yield a valuable add-on profit for their own department budget, which then is partly detached from the inflexible conventional reimbursement of radiological services.