The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Sep 2010
Case ReportsPulmonary sequestration: angioarchitecture evaluated by three-dimensional computed tomography angiography.
Pulmonary sequestration represents an anomaly of nonfunctioning tracheobronchial branching with retention of the embryonic systemic arterial supply. We report a case of intralobar pulmonary sequestration, in which the abnormal supplying artery and especially the abnormal draining vein were demonstrated by three-dimensional computed tomography angiography and were confirmed and treated using a video-assisted thoracoscopic procedure.
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Thorac Cardiovasc Surg · Sep 2010
Congenital heart surgery: applicability of hospital reimbursement according to German diagnosis-related groups system in conformity with the Aristotle complexity score.
Scores of Aristotle comprehensive complexity (ACC) levels have been demonstrated to correlate with the case-mix index (CMI) (cost-weights) generated by the German Diagnosis-Related Groups (DRG) 2009 version (G-DRG 2009). The equation used was "y = 0.5591 + 0.939 x" whereby y stands for cost-weight and x for ACC score. We hypothesised that each ACC level could be assigned a DRG (ACC DRG) and be used to determine hospital reimbursement. ⋯ The Aristotle score can be used to adjust hospital reimbursement by assigning a DRG and cost-weight value to each ACC level. Missing figures for level 6 can be obtained from a previous study which showed a mean score of 22.11 +/- 1.24: the ACC CMI would be 21.320. The 6 ACC DRGs indicate the correct compensation based on the complexity of the procedure. Reimbursement using the German DRG 2009 appears to favour less complex cases, while procedures with a higher complexity are penalised. Reimbursement according to "effective ACC CMIs" would have a strong impact by supporting units providing high-quality care.
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Thorac Cardiovasc Surg · Sep 2010
Surgical management of congenital heart disease: correlation between hospital costs and the Aristotle complexity score.
Hospital costs are expected to correlate with clinical complexity. Do costs for congenital heart surgery correlate with Aristotle complexity scores? ⋯ Aristotle comprehensive complexity scores were highly correlated with hospital costs. The Aristotle score could be used as a scale to establish the correct reimbursement after congenital heart surgery.