Diagnosis-Related Groups

Klinikeinkauf in der Schweiz: Besser werden unter veränderten Rahmenbedingungen

Klinik Einkauf ◽

10.1055/s-0039-3401486 ◽

2019 ◽

Vol 01 (04) ◽

pp. 22-23

Author(s):

Sabine Rößing

Keyword(s):

Diagnosis Related Groups

In der Schweiz steigen die Kosten für den medizinischen Sachmittelbedarf, während sich Erlöse und Rahmenbedingungen ändern – etwa mit den Swiss Diagnosis Related Groups (SwissDRG). Um Wirtschaftlichkeit bei höchster medizinischer Qualität zu erzielen, ist in den Spitälern ein Paradigmenwechsel nötig.

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Crohn’s disease: a population-based study of surgery in the age of biological therapy

International Journal of Colorectal Disease ◽

10.1007/s00384-021-03930-w ◽

2021 ◽

Author(s):

Christian Stöss ◽

Maximilian Berlet ◽

Stefan Reischl ◽

Ulrich Nitsche ◽

Marie-Christin Weber ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Minimally Invasive ◽

Biological Therapy ◽

Hospital Admissions ◽

Diagnosis Related Groups ◽

Age Distribution ◽

Considerable Proportion ◽

Discharge Data ◽

Number Of Patients

Abstract Purpose Despite primary conservative therapy for Crohn’s disease, a considerable proportion of patients ultimately needs to undergo surgery. Presumably, due to the increased use of biologics, the number of surgeries might have decreased. This study aimed to delineate current case numbers and trends in surgery in the era of biological therapy for Crohn’s disease. Methods Nationwide standardized hospital discharge data (diagnosis-related groups statistics) from 2010 to 2017 were used. All patients who were admitted as inpatient Crohn’s disease cases in Germany were included. Time-related development of admission numbers, rate of surgery, morbidity, and mortality of inpatient Crohn’s disease cases were analyzed. Results A total number of 201,165 Crohn’s disease cases were included. Within the analyzed time period, the total number of hospital admissions increased by 10.6% (n = 23,301 vs. 26,069). While gender and age distribution remained comparable, patients with comorbidities such as stenosis formation (2010: 10.1%, 2017: 13.4%) or malnutrition (2010: 0.8%, 2017: 3.2%) were increasingly admitted. The total number of all analyzed operations for Crohn’s disease increased by 7.5% (2010: n = 1567; 2017: n = 1694). On average, 6.8 ± 0.2% of all inpatient patients received ileocolonic resections. Procedures have increasingly been performed minimally invasive (2010: n = 353; 2017: n = 687). The number of postoperative complications remained low. Conclusion Despite the development of novel immunotherapeutics, the number of patients requiring surgery for Crohn’s disease remains stable. Interestingly, patients have been increasingly hospitalized with stenosis and malnutrition. The trend towards more minimally invasive operations has not relevantly changed the rate of overall complications.

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1356. Ribavirin Use in Hospitalized Children

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1538 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S689-S690

Author(s):

William R Otto ◽

Giyoung Lee ◽

Cary Thurm ◽

Jeffrey Gerber ◽

Adam Hersh

Keyword(s):

Diagnosis Related Groups ◽

Pediatric Population ◽

Health Information System ◽

International Classification Of Diseases ◽

Route Of Administration ◽

Administrative Database ◽

Hospitalized Children ◽

Syncytial Virus ◽

Tract Infections ◽

Over Time

Abstract Background Respiratory syncytial virus (RSV) infection is a significant cause of morbidity and mortality in immunocompromised children. Aerosolized ribavirin is approved for treatment of RSV lower respiratory tract infections. However, due to high cost, challenges to administration and uncertainty about benefit, use is limited. Recent studies in adult patients have reported similar outcomes between patients treated with aerosolized and oral ribavirin. We sought to characterize trends in use of ribavirin for hospitalized children. Methods We used the Pediatric Health Information System (PHIS), an administrative database which contains resource utilization data from 52 children’s hospitals, to perform a retrospective analysis of children hospitalized between January 1, 2010 through December 31, 2019 who were billed for ribavirin treatment. Data related to ribavirin use (number of courses, route of administration) and clinical characteristics were abstracted. International Classification of Diseases, 9th Revision (ICD-9) or 10th Revision (ICD-10) codes and All Patients Refined Diagnosis Related Groups (APR DRG) classifications were used to define underlying clinical conditions and illness severity. Summary statistics were used to describe patient characteristics and the use of ribavirin. Results Thirty-eight hospitals reported ribavirin use; 1 hospital was excluded due to inaccuracies in charge coding. We identified 837 children who received 937 courses of ribavirin (Table 1). The overall frequency of ribavirin use was unchanged over the study period, and the number of ribavirin treatment courses per hospital ranged from 1 to 228 (Figure 1). The most frequent routes of administration were inhalation (603/937, 64%) and oral (322/937, 34%). There was a decrease in the use of aerosolized ribavirin over time, with a corresponding increase in the use of oral ribavirin (Figure 2). Table 1: Patient demographics (N=837) Figure 1: Total ribavirin treatment courses over the study period (a) by year and (b) by treating hospital Figure 2: (a) Route of administration (inhalation versus oral), by year during the study period and (b) use of oral ribavirin over time during the study period Conclusion Although overall prescribing rates of ribavirin in hospitalized children have remained stable, use varies widely across centers and the proportion of oral ribavirin use has increased over time. Comparative effectiveness studies are needed in the pediatric population to evaluate outcomes of children treated with aerosolized vs. oral ribavirin. Disclosures All Authors: No reported disclosures

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