Woschek Mathias, Schindler Cora R, Sterz Jasmina, Störmann Philipp, Willems Laurent, Marzi Ingo, Verboket René D
Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Goethe Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
Epilepsiezentrum Frankfurt Rhein-Main und Klinik für Neurologie, Goethe Universität Frankfurt, Frankfurt am Main, Deutschland.
Z Gerontol Geriatr. 2021 Dec;54(8):802-809. doi: 10.1007/s00391-020-01828-w. Epub 2020 Dec 18.
The admission of patients with minor injuries, such as contusions is a regular practice in acute care hospitals. The pathophysiological changes resulting from the accident are seldom the primary reason for hospitalization. The aim of this retrospective monocentric study was therefore to examine the etiology as well as the cost-causing factors and refinancing on admission.
Patients were identified due to a retrospective query in the hospital information system (HIS) according to the ICD-10 German modification codes at discharge. A total of 117 patients were enrolled over a period of 2 years. The classification was carried out according to the accident mechanism and the division into age groups. In addition, the cost calculation was based on department and clinic-specific daily rates.
In terms of etiology low impact falls in the domestic environment were the most common cause (48.7%), followed by high-energy trauma (22.8%). Within the group with domestic falls, the mean age was 77.8 years. This group also showed the longest length of stay (LOS) with 5.2 days. As part of the calculated costs, the group of domestic falls showed the highest costs of 2596.24 € with an average DRG cost revenue of 1464.51 €.
The evaluation of the clinic internal data confirmed the subjective perception that the majority of patients admitted with the diagnosis of contusions came from the age group >65 years. Admission is primarily based on the increasing comorbidities and to avert secondary diseases and the consequences of immobilization. It could also be shown that the resulting costs are relevant to health economics and that the treatment does not appear to cover the costs.
在急诊医院,收治轻伤患者(如挫伤)是常规做法。事故导致的病理生理变化很少是住院的主要原因。因此,这项回顾性单中心研究的目的是检查入院时的病因、成本驱动因素及再融资情况。
根据出院时的ICD - 10德国修订编码,通过医院信息系统(HIS)的回顾性查询来确定患者。在2年时间里共纳入了117例患者。根据事故机制和年龄组划分进行分类。此外,成本计算基于科室和诊所特定的每日费率。
就病因而言,家庭环境中的低冲击力跌倒最为常见(48.7%),其次是高能创伤(22.8%)。在家庭跌倒组中,平均年龄为77.8岁。该组的住院时间也最长,为5.2天。在计算成本方面,家庭跌倒组的成本最高,为2596.24欧元,平均疾病诊断相关分组(DRG)成本收入为1464.51欧元。
对诊所内部数据的评估证实了一种主观认知,即大多数诊断为挫伤而入院的患者来自65岁以上年龄组。入院主要基于日益增加的合并症以及避免继发性疾病和固定不动的后果。还可以表明,由此产生的成本与卫生经济学相关,而且治疗似乎无法覆盖成本。