RESUMO
Based on the example of the sigmoid resection, we did a cost-income analysis evaluating the particular expenses and effects of the new DRG-based medical financing system. We analysed the cost of diagnostic tests, medication and nutrition, surgery, personnel and non medical expenses for 20 open and 27 laparoscopic operated patients. The cost of open surgery was calculated to be 3,288.44 euro per patient while laparoscopic surgery was calculated to cost 4,271.98 euro. Based on an average hospitalisation period of 16 days, the estimated income for the hospital was 5,738.98 euro. Independent of the length of hospitalisation, an income of 6,621.34 euro for the hospital was estimated using the new DRG-based medical financing system. Thus, implementation of the new DRG-based medical financing system makes it possible to give patients the benefit of shorter hospital stays following laparoscopic surgery. The cost for the hospital, however, is only minimally reduced.
Assuntos
Colo Sigmoide/cirurgia , Grupos Diagnósticos Relacionados , Laparoscopia/economia , Adulto , Idoso , Análise Custo-Benefício , Custos e Análise de Custo , Doença Diverticular do Colo/cirurgia , Feminino , Humanos , Renda , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Doenças do Colo Sigmoide/cirurgia , Fatores de TempoRESUMO
Between January 1995 and January 1999 54 Demers atrial catheters were implanted in 48 uraemic patients. Indications for implantation were: urgent need for haemodialysis with missing vascular access (39), fistula occlusion (7), low shunt flow (3) and problems with a previously implanted catheter (5). We observed 7 catheter infections, 5 catheter occlusions, 1 intraoperative air embolism, 3 haematomas and 1 dacron socket dislocation. The average period of use of an atrial catheter was 170 days, the longest period almost 2 years. The majority of catheters were explanted without any dysfunction. The long time of availability makes Demers atrial catheters an alternative to fistula for multimorbid patients on dialysis with poor long-term survival.