Breast Cancer Surgery and Financial Reimbursement in Germany

Hoffmann, Juergen; Wallwiener, D.

doi:10.1159/000343294

Cited by 7 publications

(6 citation statements)

References 6 publications

(8 reference statements)

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“…A DRG is calculated in each case from the International Statistical Classification of Diseases and Related Health Problems (ICD) code and from the Official Classification for Operation and Treatment Procedures (OPS) code [17]. In 2011, the OPS code for procedures in the breast and axilla was revised in order to reflect the work involved in complex breast operations in a more nuanced way.…”

Section: From the Point Of View Of The Certified Breast Cancer Centresmentioning

confidence: 99%

“…For example, tumour-adapted mastopexy or reduction mammoplasty during breast-conserving therapy can be coded in detail. The problem is that the procedures usually lead to the same DRG and thus to identical remuneration, no matter how complex they are [17]. Similar problems apply to ablative breast procedures as well.…”

Section: From the Point Of View Of The Certified Breast Cancer Centresmentioning

confidence: 99%

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Relevance of Health Economics in Breast Cancer Treatment - the View of Certified Breast Centres and Their Patients

Lux¹,

Hildebrandt²,

Beyer-Finkler³

et al. 2013

Breast Care

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Breast cancer centres - certified in accordance with the criteria of the German Cancer Association and the German Mastology Association - are established throughout Germany. Although the setting up of centres and the subsequent need for certification are associated with a marked increase in costs, initial data show positive effects on quality. Certified centres are cost-effective from the point of view of health economics - they lead to improved quality in processes and results without creating any increase in costs for the funding bodies. However, the organization of the necessary structures, with interdisciplinary treatment, documentation and quality-assurance measures, requires considerable resources. Increasing consolidation of inpatient services is also involved, while shortening of the patients' hospitalization periods is leading to reduced remuneration from the funding bodies. The current cost deficits, which have resulted from the increased resources required, need to be recouped through additional charges. It will only be possible to maintain the high quality achieved if additional charges become available to cover the centres' added costs. Good data are increasingly becoming available as a basis for negotiations on charges - e.g., with regard to the quality of results and the National Cancer Plan - as well as clear support from patients.

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Section: From the Point Of View Of The Certified Breast Cancer Centresmentioning

confidence: 99%

Section: From the Point Of View Of The Certified Breast Cancer Centresmentioning

confidence: 99%

Relevance of Health Economics in Breast Cancer Treatment - the View of Certified Breast Centres and Their Patients

Lux¹,

Hildebrandt²,

Beyer-Finkler³

et al. 2013

Breast Care

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“…This was also supported by a recent comparison of breast cancer DRGs in 10 European countries showing that flat-rate reimbursement can vary between different countries as well as payment over time, concluding that policy makers in 7 countries should re-evaluate their DRG systems regarding algorithms and classification for appropriateness [55]. Repeated analyses of DRGs in breast cancer treatment by clinical physicians have shown that despite a 10-year learning process German DRGs are still not cost-covering for the breast cancer care provided [33,56,57]. …”

Section: Discussionmentioning

confidence: 99%

Relevance of Health Economics in Breast Cancer Treatment: Integration of Economics in the Management of Breast Cancer at the Clinic Level

et al. 2013

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Since the introduction of the diagnosis-related groups (DRG) system with cost-related and entity-specific flat-rate reimbursements for all in-patients in 2004 in Germany, economics have become an important focus in medical care, including breast centers. Since then, physicians and hospitals have had to gradually take on more and more financial responsibilities for their medical care to avoid losses for their institutions. Due to financial limitations of resources, most medical services have to be adjusted to correlating revenues, which results in the development of a variety of active measures to understand, steer, and optimize costs, resources and related processes for breast cancer treatment. In this review, the challenging task to implement microeconomic management at the clinic level for breast cancer treatment is analyzed from breast cancer-specific publications. The newly developed economic management perspective is identified for different stakeholders in the healthcare system, and successful microeconomic projects and future aspects are described.

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“…Aufgrund der erforderlichen Expertise sind bei den rekonstruktiven Verfahren diejenigen mit mikrochirurgischen Gefäßanschlüssen aktuell die komplexesten Eingriffe. Sie sind daher in dem von Hoffmann und Wallwiener publizierten Klassifikationsschema in der höchsten Kategorie gerankt [6], was sich auch in der entsprechenden Erlössituation über Fallpauschalen wiederfindet [7]. Perforatordarstellung mit apparativen Methoden ▼ Die aktuelle Forschungssituation zu freien Transplantaten beschäftigt sich bereits seit längerem mit den apparativen Möglichkeiten der Gefäßlokalisation [9], um eine Verkürzung der Operationsdauer und auch eine Patientinnen-Selektion bezüglich der individuellen Gefäßsituation vornehmen zu können.…”

Section: Eingruppierung Nach Komplexität Der Methode ▼unclassified