ABSTRACT
Since 1991 Diagnostic Related Groups (DRGs) are systematically developed for standardized operation procedures. They are included in a Quality Management System of the DIN EN ISO 9001 ff. norm and are part of the process system. In additional the internal and external evaluation of quality completes a Modular Quality Management System (MQM). These procedures meet the requirements for a Total Quality Management (TQM).
Subject(s)
Fees, Medical/classification , Hospital Charges/organization & administration , Hospital Costs/organization & administration , Practice Guidelines as Topic , Surgical Procedures, Operative/economics , Total Quality Management/organization & administration , Algorithms , Cost Control/organization & administration , Germany , Humans , Total Quality Management/economicsSubject(s)
Blood Coagulation Tests , Blood Platelets , Hemorrhagic Disorders/blood , Blood Cell Count , Capillary Fragility , Diagnosis, Differential , Factor IX/analysis , Factor V/analysis , Factor VII/analysis , Factor VIII/analysis , Humans , Platelet Adhesiveness , Prothrombin/analysis , Prothrombin TimeABSTRACT
PIP: 42 patients, 11 males and 31 females, were studied in the diagnostical evaluation of von Willebrand's disease. The 28 adult females suffered from uterine hemorrhagia. The parameters used in the determination of the coagulation system and platelet function are listed. The findings of prolonged bleeding time and reduced factor 8 were obligatory in confirming the diagnosis of von Willebrand's disease, supported by impared platelet adhesiveness, an abnormal capillary resistance, in severely affected patients by a prolongation of reaction and clot formation time and finally by an increase of widely spread platelets. There was evidence of reactive platelet behavior. 14 patients received prophylactic cyclic or continuous long-term therapy using an estrogen and progestin (Eugynon, Orgaluton, and Orgametril) for from 6 months to 4 years. Therapy was without improvement of hemostaseologic findings, although cyclic long-term therapy resulted in normalization of menstrual bleeding.^ieng