Nusshag Christian, Obermann Konrad, Weigand Markus, Schwenger Vedat
Klinik für Nephrologie, Universitätsklinikum Heidelberg.
Mannheim Institute of Public Health (MIPH), Universität Heidelberg.
Dtsch Med Wochenschr. 2017 Apr;142(7):534-540. doi: 10.1055/s-0042-120808. Epub 2017 Apr 7.
Since 2005 the AKI numbers nearly increased threefold. The prevailing health care structure for AKI-management in Germany possesses major potential for improvement. Despite a clear advantage regarding mortality and renal recovery, the cost-intensive CRRT is the predominant procedure in AKI-therapy. Conversion of 85 % of the CRRT-procedures to a dialysis procedure (IHD/SLED) enables annual savings in AKI-therapy by 7.3 million Euros. A reinvestment can finance a strengthened collaboration with licensed nephrologists to improve therapy quality and availability of RRT-units in local hospitals. The the long term aim is the establishment of national therapy guidelines. Lower consequential costs are crucial incentives.
自2005年以来，急性肾损伤（AKI）病例数几乎增长了两倍。德国现行的AKI管理医疗保健结构有很大的改进潜力。尽管在死亡率和肾脏恢复方面有明显优势，但成本高昂的连续性肾脏替代治疗（CRRT）却是AKI治疗中的主要手段。将85%的CRRT治疗转换为透析治疗（间歇性血液透析/缓慢低效血液透析），每年可在AKI治疗中节省730万欧元。再投资可以为加强与有执照的肾病专家的合作提供资金，以提高治疗质量和当地医院肾脏替代治疗单位的可及性。长期目标是制定国家治疗指南。降低间接成本是关键的激励因素。
