[Cost and Income Analysis of the 10 Most Frequent Angiography Interventions at a German University Hospital]. / Analyse von Kosten und Erlösen der 10 häufigsten angiografischen Interventionen bei einem Krankenhaus der Maximalversorgung.

ABSTRACT

Aim: Our aim was to make a detailed evaluation and cost analysis of the 10 most frequent angiography interventions in outpatients and inpatients at a university hospital. Material and Methods: Based on a detailed process-oriented model we calculated the cost and income for port and dialysis catheter implantation, PTA at the upper (UL) and lower leg (LL), TACE, SIRT, stent angioplasty (pelvis, visceral and supra-aortal vessels) and cerebral coil embolisation for the situations mentioned above. Various income models (DRG, GOÄ) were considered. A comprehensive evaluation of the overhead and personnel costs was performed. Results: The calculated data (in €) were as follows (overall, material, personnel costs, DRG income, GOÄ income inpatients, outpatients) port catheter 375, 266, 59, 328, 260, 612; dialysis catheter 456, 349, 59, 272, 343, 807; PTA UL 595, 445, 99, 1 240, 425, 1 077; PTA LL 732, 552, 129, 1 082, 425, 1 184; stent pelvis 1 523, 1 338, 135, 1 323, 815, n/a; stent visceral 2 124, 1 875, 199, 1 326, 912, n/a; stent supra-aortal 1 901, 1 713, 138, 6 705, 1 138, n/a; TACE 1 359, 1 120, 188, 2 588, 598, n/a; SIRT 1 251, 1 054, 147, 2 289, 1 107, n/a; intracranial embolisation 6 684, 6 367, 266, 6 531, n/a, n/a. Conclusion: Depending on the income model applied, most procedures caused a deficit, especially using GOÄ calculations. Outpatients covered by the private health insurance caused earnings for the procedures applied. Only TACE, SIRT and stent angioplasty of supra-aortal vessels caused profits in inpatients using InEK calculations.