Finger R P, Köberlein-Neu J, Gass P, Holz F G, Bertram B
Universitätsaugenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland.
Ophthalmologe. 2013 Mar;110(3):224-9. doi: 10.1007/s00347-012-2751-4.
Over the last decade inpatient treatment has been reduced in favor of outpatient care or markedly shortened inpatient stays in most organ-specific surgical specialties such as ophthalmology in Germany.
Data from the federal statistics agency on the international classification of disease (ICD), diagnosis-related groups (DRG) and performed operations and procedures from 2000 to 2010 as well as data from the Institute for Reimbursements of Hospitals (InEK) on average costs per DRG in every German DRG (G-DRG) version from 2004 to 2010 were analyzed for ophthalmology.
From 2000 to 2010, the number of cases with a main ophthalmological diagnosis decreased (-19 %), which was mostly due to a reduction in the number of cataract inpatients (-56 %). All subspecialties such as glaucoma (+82 %) and retina (+68 %) with the exception of primary strabismus diagnoses (-15 %) gained in number of cases. Inpatient cataract surgery was the most common surgery in 2004 but numbers decreased to 2010 (-9 %). The most often performed inpatient procedure was vitreoretinal surgery in 2007 and 2010 (increase 2004-2010 + 46 %). Average hospital stay decreased between 2005 and 2010 from 3.9 to 3.4 days and the average cost per case increased by 3.6 % overall and by 13.4 % for surgical cases.
Ophthalmic healthcare provided as inpatient services decreased with a trend towards more complex cases being treated as inpatients from 2000 to 2010.
在过去十年中,德国多数器官特异性外科专业(如眼科)减少了住院治疗,转而倾向于门诊护理或显著缩短住院时间。
分析了联邦统计局提供的2000年至2010年疾病国际分类(ICD)、诊断相关分组(DRG)以及所实施手术和操作的数据,以及医院报销研究所(InEK)提供的2004年至2010年德国每个DRG版本(G-DRG)中每个DRG的平均费用数据,这些数据均针对眼科。
2000年至2010年,主要眼科诊断病例数减少了19%,这主要是由于白内障住院患者数量减少了56%。除原发性斜视诊断病例数减少了15%外,所有亚专业(如青光眼增加了82%,视网膜增加了68%)的病例数均有所增加。住院白内障手术在2004年是最常见的手术,但到2010年数量减少了9%。2007年和2010年最常实施的住院手术是玻璃体视网膜手术(2004年至2010年增加了46%)。2005年至2010年,平均住院时间从3.9天降至3.4天,每例平均费用总体增加了3.6%,手术病例增加了13.4%。
2000年至2010年,住院眼科医疗服务减少,且有将更复杂病例作为住院患者治疗的趋势。