Schwendler M, Hübner C S, Fleßa S
Lehrstuhl für Allgemeine Betriebswirtschaftslehre und Gesundheitsmanagement, Universität Greifswald, Greifswald.
Gesundheitswesen. 2017 Oct;79(10):855-862. doi: 10.1055/s-0042-106897. Epub 2016 Jun 14.
Infection with methicillin-resistant Staphylococcus aureus (MRSA) occurs in both the inpatient and outpatient sector. The reimbursement for diagnostic services and eradication therapy in the outpatient sector was regulated for the first time on 01.04.2012 and after a 2-year test period, has been adopted into the standard range of care services. The aim of this retrospective study was to give an overview of the current situation in services and reimbursement in Germany and describe MRSA patients and their treatment in the outpatient sector. Secondary data, namely reimbursement data of the National Association of Statutory Health Insurance Physicians (KBV) und the Physicians' Association (KV) Mecklenburg-West Pomerania for the period 01/04/2012-31/03/2014 were analyzed. Results show that on the federal level, MRSA services amounting to € 3,235,870.18 have been reimbursed and that diagnostic costs exceed treatment costs. In Germany, 5,627 doctors invoiced services related to MRSA; 51,56% of these were general practitioners and 21,25% specialists in internal medicine working in general practice. In the KV Mecklenburg-Western Pomerania, patients were elderly (average age 69,13), cost for services were on average 27,76 €, and 76,85% of the patients were treated within one quarter. On the whole, there were regional differences in the identification and eradication of MRSA in the outpatient setting. In order to provide an extended base for a more efficient resource allocation in the health care sector, in addition to analysis of MRSA eradication from the medical point of view, attention needs to be paid to patient flow between the out- and inpatient sectors, as well as economic aspects.
耐甲氧西林金黄色葡萄球菌(MRSA)感染在住院和门诊部门均有发生。门诊部门诊断服务和根除治疗的报销于2012年4月1日首次得到规范,经过两年的试行期后,已被纳入标准护理服务范围。这项回顾性研究的目的是概述德国服务和报销的现状,并描述门诊部门的MRSA患者及其治疗情况。分析了二级数据,即全国法定医疗保险医生协会(KBV)和梅克伦堡-前波美拉尼亚医生协会(KV)在2012年4月1日至2014年3月31日期间的报销数据。结果显示,在联邦层面,已报销的MRSA服务费用达3,235,870.18欧元,且诊断成本超过治疗成本。在德国,5627名医生开具了与MRSA相关的服务发票;其中51.56%是全科医生,21.25%是从事全科医疗的内科专科医生。在梅克伦堡-西波美拉尼亚KV地区,患者年龄较大(平均年龄69.13岁),服务费用平均为27.76欧元,76.85%的患者在一个季度内接受了治疗。总体而言,门诊环境中MRSA的识别和根除存在地区差异。为了在医疗保健部门提供更广泛的基础以实现更有效的资源分配,除了从医学角度分析MRSA根除情况外,还需要关注门诊和住院部门之间的患者流动以及经济方面。