Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
-
The forthcoming introduction of a DRG-based account system in Germany aims at higher transparency and economic efficiency, particularly in the sector of in-patient health care. The availability of documentation of the highest quality, taking into account all potentially relevant diagnoses, appears to be the best method for achieving maximum revenue in individual surgical units. The aim of the study was to determine the relevance of various degrees of documentation depth on calculated DRG-based revenue. Furthermore, we evaluated whether improvements in the quality of documentation can be realized in current hospital organization. ⋯ Documentation depth has an important influence on the calculated revenue of surgical therapy based on AR-DRG system. The quality and depth of the documentation is not, in itself, sufficient. In order to be really effective, it requires the highest degree of professionalism from hospital staff.
-
Randomized Controlled Trial Comparative Study Clinical Trial
[3-dimensional computer animation--a new medium for supporting patient education before surgery. Acceptance and assessment of patients based on a prospective randomized study--picture versus text].
The rigorous implementation of clear preoperative information is mandatory for the patient's understanding, acceptance and written informed consent to all diagnostic and surgical procedures. In the present study, I evaluated whether new media are suitable for conveying basic information to patients; I analysed the merits of computerized animation to illustrate a difficult treatment process, i.e., the progressive steps of a thyroid operation, in comparison to the use of conventional flyers. ⋯ Preoperative surgical information can be optimized by presenting the operative procedure via computer animation. Nowadays, several types of new media such as the world wide web, CD, DVD, and digital TV are readily available and--as shown here--suitable for effective visual explanation. Most patients are familiar with acquiring new information by one of these means. An appropriately designed 3D repre-sentation is met with a high level of acceptance, as the present study clearly shows. Modern patient-based information systems are necessary. They can no longer be the sole responsibility of the medical profession, but must be on the agenda of hospital managements and of medical care systems as well.
-
Comparative Study
["Simplified Acute Physiology Score" (SAPS II) ina the assessment of severity of illness in surgical intensive care patients].
In 1993, Le Gall proposed a new Simplified Acute Physiology Score (SAPS II) to assess the severity of illness in intensive care patients and to predict the risk of hospital mortality using a large data base of more than 13,000 patients of different intensive care units. Up to the present time, no satisfactory form of validation for surgical intensive care patients has been available. We investigated the prognostic quality of this score system for the assessment of the severity of the illness in surgical intensive care patients. ⋯ The SAPS II score has proved to be a good prognostic instrument in surgical intensive care patients. SAPS II is particularly effective in providing an exact estimation of the risk of death, classifying patient groups in clinical studies, epidemiological investigations, and quality assessment.
-
The continual development of the internet has supported the spread of surgical knowledge by electronic means. High quality products have to be offered from a software as well as a contents point of view. The question as to whether these new media and their contents have a real value for efficient and motivating use in medical education needed to be answered by first assessing a quality profile for the development of surgical educational modules which were then evaluated on the basis of so-called "symposia ware". ⋯ To enhance illustration, a picture and video-oriented visualization should be chosen. Overall, "symposia ware" is rated positively. It should cost no more than 50 EUR and it represents a valuable source of information for physicians.
-
Subjective experiences of patients during their stay in the intensive care unit (ICU) have so far rarely been described. The aim of this study was to analyze the experiences of patients during their stay in the ICU. ⋯ The study results led to several practical consequences in the quality of management procedure (e.g., the introduction of a thorough night's rest at the ICU, optimized information for patients). Additionally, we initiated further studies concerning the quality of life of ICU patients.