Department of Paediatric and Adolescent Surgery, Medical University of Graz, 8036 Graz, Austria.
Austrian Society of Paediatric and Adolescent Surgery, 1010 Vienna, Austria.
Int J Environ Res Public Health. 2021 Oct 24;18(21):11166. doi: 10.3390/ijerph182111166.
Neonatal "surgical" malformations are associated with higher costs than major "non-surgical" birth defects. We aimed to analyze the financial burden on the Austrian health system of five congenital malformations requiring timely postnatal surgery. The database of the Austrian National Public Health Institute for the period from 2002 to 2014 was reviewed. Diagnosis-related group (DRG) points assigned to hospital admissions containing five congenital malformations coded as principal diagnosis (esophageal atresia, duodenal atresia, congenital diaphragmatic hernia, gastroschisis, and omphalocele) were collected and compared to all hospitalizations for other reasons. Out of 3,518,625 total hospitalizations, there were 1664 admissions of patients with the selected malformations. The annual mean number was 128 (SD 17, range 110-175). The mean cost of the congenital malformations per hospital admission expressed in DRG points was 26,588 (range 0-465,772, SD 40,702) and was significantly higher compared to the other hospitalizations ( = 3,516,961; mean DRG 2194, range 0-834,997; SD 6161; < 0.05). Surgical conditions requiring timely postnatal surgery place a significant financial burden on the healthcare system. The creation of a dedicated national register could allow for better planning of resource allocation, for improving the outcome of affected children, and for optimizing costs.
新生儿“外科”畸形的治疗费用高于主要的“非外科”出生缺陷。我们旨在分析奥地利卫生系统需要及时进行产后手术的五种先天性畸形的经济负担。回顾了奥地利国家公共卫生研究所 2002 年至 2014 年期间的数据库。收集了与作为主要诊断编码的五种先天性畸形（食管闭锁、十二指肠闭锁、先天性膈疝、腹裂和脐膨出）相关的医院入院的诊断相关组（DRG）点数，并与其他原因的所有住院治疗进行了比较。在 3518625 例总住院治疗中，有 1664 例患者因所选畸形入院。每年的平均数量为 128 例（SD 17，范围 110-175）。以 DRG 点数表示的每例先天性畸形住院的平均费用为 26588 欧元（范围 0-465772，SD 40702），明显高于其他住院治疗（=3516961；平均 DRG 2194，范围 0-834997；SD 6161；<0.05）。需要及时进行产后手术的外科情况给医疗保健系统带来了重大的经济负担。创建一个专门的国家登记册可以更好地规划资源分配，改善受影响儿童的预后，并优化成本。
