Ist ein Brustzentrum finanzierbar? – Berechnung einzelner Leistungen am Beispiel des Universitäts-Brustzentrums Franken (UBF)

Wagner, Simon D.; Bani, M. R.; Fasching, Peter A.; Schrauder, Michael G.; Löhberg, Christian; Beckmann, Matthias W.; Lux, Michael P.

doi:10.1055/s-2008-1039170

Cited by 18 publications

(17 citation statements)

References 9 publications

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“…These include work involved in (re-)certification processes and costs for meeting obligatory quality criteria such as further education and training [13], research involving molecular and clinical studies, multiple documentation (e.g., for the Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen, AQUA and for maintaining a clinical and epidemiological cancer registry), coordination of the centre, additional support for affected patients and their families, and provision of infrastructure for interdisciplinary partners. The individual costs of a certified breast cancer centre have been examined in other analyses [10,14]. It was found that setting up a quality management system alone, with the costs of certification and annual audits, involves costs of € 237,303 over 4 years.…”

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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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%

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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“…Individual cost aspects in a certified breast center were investigated in another study by Wagner et al [21]. Establishing the required quality management system alone, with subsequent certification and annual audits, resulted in additional costs of €237,303 over 4 years.…”

Section: The Cost Side Of Certified Breast Centersmentioning

confidence: 99%

Are Certified Breast Centers Cost-Effective?

Beckmann¹,

Bani²,

Loehberg³

et al. 2009

Breast Care

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The German health care system has entered an era of specialist centers and certification. Hospitals are required to introduce quality management with external monitoring, refining and improving their quality of treatment. These statutory requirements can only be met through specialization, centralization, and establishing centers and networks with internal and external interdisciplinary collaboration. The breast centers certified according to the criteria of the German Cancer Society (DKG) and German Society for Mastology (DGS) are pioneers here. Simultaneously, there are increasing demands for more cost-effective medical services despite limited resources – making economic analysis of health care provision necessary. Few economic studies of the centers and certification system have been conducted, however. General long-term quality data, particularly for results, are not yet available from certified breast centers. At present, a certified breast center is not itself a proven independent prognostic parameter for treatment results. However, the individual criteria required for breast center certification show a significant positive influence on clinical efficacy. Certified breast centers involve substantial extra costs that are not reimbursed by funding bodies, so the slightest potential benefit for patients from certified centers already appears cost-effective. When the actual costs, currently usually subsidized by other departments, are considered, it is unclear whether certified breast centers remain cost-effective.

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“…Theuseofbreastimplantsorexpandersfora100%immedi-atereconstructionrateaftermastectomywas,onaverage,by 90.3% not cost covering for patients at the University of CologneBreastCenterin2009 [11].TheaveragebreastimplantcostsareconfirmedbyanotherGermanbreastcenter with Ø € 683.27 (-2.3%) [12], and therefore comparable. Ouraverageimplantcostsareevenhigherthancalculatedbecause(1)mesh-occasionallyusedtofixateprostheseslaterally under the pectorals muscle -were excluded from this calculation and (2) routine antibiotic rinsing of implants pre insertion with pharmaceutical costs of~ € 50 per case were also not included.…”

Section: Discussionmentioning

confidence: 89%

Underfinancing of 90.3% for Implant Costs of Prostheses and Expanders in DRG Revenues for Uni- and Bilateral Mastectomy with Immediate Breast Reconstruction

Jacobs¹,

Rasche²,

Harbeck³

et al. 2010

Onkologie

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Background: From the clinic’s point of view economic patient care requires comparison and adjustment of costs to revenues. To verify cost coverage for implants in mastectomy with immediate breast reconstruction, a comprehensive cost-reimbursement analysis was performed. Methods: Retrospective analysis of the German diagnosis-related group (G-DRG) revenues for implants from the DRG Browser 2007/2009HA and comparison with actual costs for implants in 2009 from the annual clinic report and the database of the controlling department. Calculation of the relative cost coverage for implants in unilateral (DRG J06Z) and bilateral mastectomy (DRG J16Z). Results: In 2009, n = 98 J06Z and n = 18 J16Z were performed. DRG-calculated expenses for implants were € 69.65 for J06Z and € 123.07 for J16Z, i.e. a total of € 9,040.96. Actual costs for all implants were € 121,645.60, mean € 699.11 (€ 404.94–1,171.44). Attributable implant costs for 100% immediate breast reconstruction rate were € 93,679.28. Thus, implants are not cost covering by –90.3% (–82.8 to –94.7%). Subsidies for implants from the clinic’s budget range from € 335.29 to € 2,219.81 per case. Conclusions: Immediate breast reconstruction with implants after mastectomy is – even 6 years after introduction of the DRGs – not adequately calculated to be cost covering since the actual implant costs exceed the calculated revenues by far. At present, these implants are subsidized by the clinic at, on average, 90.3%. If economic patient care is mandatory, a maximum of only 1 in 10 patients with mastectomy can be offered immediate breast reconstruction with implants in Germany.

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Ist ein Brustzentrum finanzierbar? – Berechnung einzelner Leistungen am Beispiel des Universitäts-Brustzentrums Franken (UBF)

Cited by 18 publications

References 9 publications

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

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

Are Certified Breast Centers Cost-Effective?

Underfinancing of 90.3% for Implant Costs of Prostheses and Expanders in DRG Revenues for Uni- and Bilateral Mastectomy with Immediate Breast Reconstruction

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