Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Due to increasing medical costs and yet limited financial resources, medical treatment and economic analyses can no longer be separated; therefore, direct costing and cost unit accounting become more and more relevant as controlling tools in hospital management. Transthoracic esophagectomy is an integral part of the current treatment concept in patients with esophageal carcinoma. The question of the present study was whether the present diagnosis-related groups (DRG) system is a cost-effective tool to represent transthoracic esophagectomy. ⋯ With increasing complication score the profit margin became increasingly negative (Clavien-Dindo I: -2878 €, Clavien-Dindo IVb: -58,543 €). Within the analysis of the InEK target cost matrix, main cost drivers can be identified as medical services (22.3%) and non-medical infrastructure (18.7%). Surgical treatment according to the existing guidelines of patients with esophageal carcinoma is not cost-covering in high-volume centers and cannot be solely financed by existing DRG revenues.