[Increased revenues from secondary diagnoses : A comparison from dermatology, ophthalmology, and infectious diseases]. / Mehrerlöse durch Nebendiagnosen : Ein Vergleich von Dermatologie, Ophthalmologie und Infektiologie.

BACKGROUND: Hospital revenues generated by diagnosis-related groups (DRGs) are in part dependent on the coding of secondary diagnoses. Therefore, more and more hospitals trust specialized coders with this task, thereby relieving doctors from time-consuming administrative burdens and establishing a highly professionalized coding environment. However, it is vastly unknown if the revenues generated by the coders do indeed exceed their incurred costs. METHODS: Coding data from the departments of dermatology, ophthalmology, and infectious diseases from Rostock University Hospital from 2007-2016 were analyzed for the effects of secondary diagnoses on the resulting DRG, i. e., hospital charges. RESULTS: Ophthalmological case were highly resistant to the addition of secondary diagnoses. In contrast, adding secondary diagnoses to cases from infectious diseases resulted in 15% higher revenues. Although dermatological and infectious cases share the same sensitivity to secondary diagnoses, higher revenues could only rarely be realized in dermatology, probably owing to a younger, less multimorbid patient population. CONCLUSION: Except for ophthalmology, trusting specialized coders with clinical coding generates additional revenues through the coding of secondary diagnoses which exceed the costs for employing these coders.

[Psychological aspects of the preparation and performance of endoscopies in children and adolescents]. / Psychische Aspekte bei der Vorbereitung und Durchführung von Endoskopien bei Kindern und Jugendlichen.

Individual observations lead to the realisation that during endoscopy children may develop such a degree of seemingly unexplainable anxiety that the performance of the examination is considerably prejudiced. We therefore examined 39 children systematically, evaluating them according to fearsome products of their imagination on the one hand and real or warranted anxiety on the other. Adjusted to age the children were tested using drawings, projectional tests and role-playing in addition to interviewing, sometimes of their parents as well. The most prominent expressions of anxiety in conjunction with endoscopy were fear of suffocation; fear of damage to internal organs and, in girls, fear of lesions to a "baby inside". In adolescents problems with prudery became evident. On the basis of our experience we developed a systematic model of psychological preparation for endoscopic examinations.