Ali Modabber1, Daniel Schick2, Evgeny Goloborodko3, Florian Peters3, Marius Heitzer3, Anna Bock3, Kristian Kniha3, Frank Hölzle3, Elke M Schreiber4, Stephan Christian Möhlhenrich5. 1. Department of Oral, Maxillofacial and Facial Plastic Surgery, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany. amodabber@ukaachen.de. 2. Department of Intensive Care Medicine, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany. 3. Department of Oral, Maxillofacial and Facial Plastic Surgery, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany. 4. University Hospital of Johannes Gutenberg University Mainz, Mainz, Germany. 5. Department of Orthodontics, University of Witten/Herdecke, Witten, Germany.
Abstract
BACKGROUND: Certification of multidisciplinary tumor centers is nowadays seen as the gold standard in modern oncological therapy for optimization and realization of guideline-based therapy and better outcomes. Single cases are reimbursed based on diagnosis-related groups (DRG). We aimed to review efficiency, cost analysis, and profitability following a certification. METHODS: Tumor board certification at the university hospital Aachen was implemented in 2013. We compared 1251 cases of oropharyngeal cancer treated from 2008 to 2017 before and after certification. For this purpose, several patient characteristics, surgery, and stay-related constants, as well as expenses and reimbursement heights were analyzed statistically. RESULTS: Following certification, the total case and patient number, surgery duration, hours of mechanical ventilation, case mix index points, DRG reimbursements as well as the costs increased significantly, whereas days of intensive care unit, amount of blood transfusions, patient clinical complexity level (PCCL) and the overall stay were significantly lowered. No changes were observed for the patient's age and gender distribution. Also, the predetermined stay duration stayed constant. CONCLUSIONS: Certification of head-neck tumor centers causes a concentration of more complex cases requiring higher surgical efforts, which can be processed more efficiently due to a higher level of professionalism. Despite their benefits in cancer care, without compensation, centers may be struggling to cover their expenses in a system, which continuously underestimates them.
BACKGROUND: Certification of multidisciplinary tumor centers is nowadays seen as the gold standard in modern oncological therapy for optimization and realization of guideline-based therapy and better outcomes. Single cases are reimbursed based on diagnosis-related groups (DRG). We aimed to review efficiency, cost analysis, and profitability following a certification. METHODS:Tumor board certification at the university hospital Aachen was implemented in 2013. We compared 1251 cases of oropharyngeal cancer treated from 2008 to 2017 before and after certification. For this purpose, several patient characteristics, surgery, and stay-related constants, as well as expenses and reimbursement heights were analyzed statistically. RESULTS: Following certification, the total case and patient number, surgery duration, hours of mechanical ventilation, case mix index points, DRG reimbursements as well as the costs increased significantly, whereas days of intensive care unit, amount of blood transfusions, patient clinical complexity level (PCCL) and the overall stay were significantly lowered. No changes were observed for the patient's age and gender distribution. Also, the predetermined stay duration stayed constant. CONCLUSIONS: Certification of head-neck tumor centers causes a concentration of more complex cases requiring higher surgical efforts, which can be processed more efficiently due to a higher level of professionalism. Despite their benefits in cancer care, without compensation, centers may be struggling to cover their expenses in a system, which continuously underestimates them.
Authors: Laurie A Loevner; Adina I Sonners; Brian J Schulman; Kerstin Slawek; Randal S Weber; David I Rosenthal; Gul Moonis; Ara A Chalian Journal: AJNR Am J Neuroradiol Date: 2002 Nov-Dec Impact factor: 3.825
Authors: Désirée Thommen; Noemi Weissenberger; Philipp Schuetz; Beat Mueller; Christoph Reemts; Thomas Holler; Juerg A Schifferli; Martin Gerber; Balthasar L Hug Journal: Swiss Med Wkly Date: 2014-06-25 Impact factor: 2.193