[Cost-revenue aspects of endovascular treatment of distal aortic arch pathologies with respect to the introduction of a new thoracic side-branch prosthesis].

Background: The standard vascular surgical procedure (SV) for the treatment of distal aortic arch pathologies involves a hybrid approach using a left carotid-subclavian bypass and thoracic endovascular aortic repair. Considering the introduction of a thoracic side branch prosthesis (TBE), the aim of this study was to analyze the cost-revenue aspects of both procedures.

Material And Methods: A retrospective analysis was conducted on cases treated by SV from 2017 to 2022.

[Reorientation of the hospital planning in NRW-Importance for cardiovascular medicine and thoracic surgery].

The year 2022 will mark the beginning of a new era for hospitals in North Rhine-Westphalia. With the reorganization of hospital planning in NRW to an allocation of treatment assignments via specialized medical service groups with personnel and infrastructural structural quality requirements specific for this purpose instead of via specialized departments and beds, a new form of hospital planning and structuring is implemented. This method is now proposed by the "government commission for a modern and needs-based hospital treatment" implemented by the Minister of Health Lauterbach as a structurization option for the whole of Germany in combination with hospital treatment levels.

[Rheumatology centers according to the regulations of the Federal Joint Committee].

With the Nursing Staff Strengthening Act (Pflegepersonal-Stärkungs-Gesetz), the legislator delegated the specification of the special tasks of centers and focal points to the Federal Joint Committee (G-BA). Due to extensive preliminary work it was already possible to agree on quality requirements and special tasks for rheumatology centers and centers for pediatric and adolescent rheumatology in the first version of the G‑BA regulations. Since publication in the Federal Gazette (Bundesanzeiger) on 12 March 2020, rheumatology centers have been able to negotiate surcharges for their special tasks if they have been designated accordingly by the state authorities responsible for hospital planning.

[Rheumatologic inpatient treatment-more than a complex treatment : Data reflecting services and structures].

To review and be prepared for upcoming reforms, data from the InEK (Institut für das Entgeltsystem im Krankenhaus, institute for remuneration in hospitals) data browser and the structured quality reports for inpatient rheumatologic treatment were evaluated. Rheumatologic treatment is very diversified, both in terms of diagnoses and structures. Different specializations can be identified.

[Quality in acute inpatient rheumatology 2021 : Current aspects of the KOBRA quality label of the Association of Rheumatological Acute Care Clinics].

A comprehensive health policy quality campaign launched in 2021 aims to improve the quality and transparency of hospital care for people with diseases in Germany. Legal requirements for minimum volumes and the expansion of quality contracts between cost units and hospitals as well as the use of quality indicators relevant to planning for demand-oriented and quality-oriented further development of inpatient care will increase competition in the quality of care between hospitals. The topic of development and definition of quality in medicine was also comprehensively addressed by the Association of Rheumatological Acute Care Clinics (VRA) shortly after its foundation in 1998.

[Complex treatments in rheumatology and geriatrics - Challenges - Differences - Chances].

With the introduction of the German diagnostic-related groups (G-DRG) system in 2003, remuneration according to DRG was also implemented for the disciplines of rheumatology and geriatrics. For acute inpatient treatment in the field of rheumatology the specialized complex rheumatological treatment (OPS code 8-983) and the related DRG-I97Z (rheumatological complex treatment for diseases and disorders of the musculoskeletal system and connective tissue) were assigned to the DRG system in 2005 and 2006, respectively. The early complex geriatric rehabilitation (OPS code 8-550) is a tool in the treatment of older patients affected by rheumatism.

[Hospital financing in 2016. Relevant changes for rheumatology].

Hospital financing 2016 will be influenced by the prospects of the approaching considerable changes. It is assumed that the following years will lead to a considerable reallocation of financial resources between hospitals. While not directly targeted by new regulations, reallocations always also affect specialties like rheumatology.

[Hospital financing in 2015. Relevant changes for rheumatology].

The announced major reforms will most probably not have an impact on hospital financing before 2016. Nevertheless, the numerous minor changes in the legislative framework and the new version of the German diagnosis-related groups (G-DRG) system can be important for hospitals specialized in rheumatology. The following article presents the relevant changes and discusses the consequences for hospitals specialized in rheumatology.

Cerebrovascular events in HIV-infected patients: an analysis of a cohort of 3203 HIV+ patients during the times of cART.

Purpose/aim: Cerebrovascular events (CVE) in HIV infected patients have become an increasingly relevant neurological complication. Data about the prevalence and clinical features of CVE in HIV infected patients since the introduction of combined Anti-Retroviral Therapy (cART) are rare.

Methods: A retrospective study of HIV-infected patients with a CVE was performed from 2002 to 2011.

Shaping the System - The DRG Evaluation Project of the German Society for Gynaecology and Obstetrics (Deutsche Gesellschaft für Gynäkologie und Geburtshilfe, DGGG).

The German DRG system is annually adapted to the changing services provided. For the further development, the self-governing body and its DRG Institute (InEK) depend on participation of the users. For one of the DRG evaluation projects initiated by DGGG, cost and performance data for the year 2011 from 16 hospitals were available.

[Hospital financing in 2014. Relevant changes for rheumatology].

As with others medical disciplines hospitals specialized in rheumatology again face heavy economic burdens in 2014. To meet the challenges knowledge of the new German diagnosis-related groups (G-DRG) system, the legislative framework and current jurisprudence can be helpful. The following article presents the major changes and discusses the consequences for hospitals specialized in rheumatology.

[The significance of the principal diagnosis in Germany's new payment system for inpatient treatment of mental disorders].

In 2013 Germany implemented a new payment system for the inpatient treatment of mental disorders. Besides perpetuating a per-diem payment, the payment system sets up a classification system that groups cases with comparable costs per diem. The first release of the system reveals the principal diagnosis to be the main grouping variable.

Mycobacterium kansasii isolation from captive South American coati (Nasua nasua).

Three of six captive South American coatis (Nasua nasua) presented with respiratory distress and died despite treatment. Postmortem examination performed on two of these animals revealed granulomatous pleuropneumonia associated with acid-fast bacilli. Because of the possible diagnosis of mycobacterial infection, the three remaining asymptomatic coatis were anesthetized.

[Hospital financing in 2013: relevant changes for rheumatology].

Hospital financing is again subjected to a multitude of reforms that can be of relevance for rheumatology in 2013. Besides changes in the German diagnosis-related group (G-DRG) classification system and coding, modifications in the legislation and legal framework conditions have a growing impact on the economic situation and strategy of hospitals. The following article presents the major changes and discusses consequences for hospitals specialized in rheumatology.

Cost Analysis of Integrative Inpatient Treatment Based on DRG Data: The Example of Anthroposophic Medicine.

Background. Much work has been done to evaluate the outcome of integrative inpatient treatment but scarcely the costs. This paper evaluates the costs for inpatient treatment in three anthroposophic hospitals (AHs).

[Hospital financing in 2012 - Relevant changes for rheumatology].

The following article presents the major general and specific changes for the financing of rheumatology in Germany for 2012. Besides relevant changes in the German diagnosis-related groups (G-DRG) classification system and for the coding, the new legislation and the resulting incentives are covered. The consequences for hospitals specialized in rheumatology are discussed.

[Hospital financing for 2011: relevant changes in rheumatology].

The following article presents the major general and specific changes for rheumatology in the financing of inpatient care in Germany for 2011. In addition to relevant changes in the G-DRG classification system and coding, the new legislation and insurance company auditing procedures are covered. The impact these changes will have on hospitals specialized in rheumatology is discussed.

[The G-DRG System 2009--relevant changes for rheumatology].

The following article presents the major general and specific changes in the G-DRG system, in the classification systems for diagnoses and procedures as well as for the billing process for 2010. Since the G-DRG system is primarily a tool for the redistribution of resources, every hospital needs to analyze the economic effects of the changes by applying the G-DRG transition-grouper to its own cases. Depending on their clinical focus, rheumatological departments may experience positive or negative consequences from the adjustments.

[G-DRG system 2009: relevant changes for rheumatology].

The following article presents the main general and specific changes in the G-DRG (German diagnosis-related groups) system in terms of the classification systems for diagnoses and procedures as well as the billing process for 2009. Of fundamental relevance is the national weighting of the G-DRG I97Z (complex rheumatologic treatment), which up to now had to be negotiated individually by each hospital. Emphasis is also put on case auditing by the health insurers.

[The G-DRG system 2008. Relevant changes for rheumatology].

The G-DRG system 2008 once again brings many changes to rheumatological departments in Germany. The following article presents the main general and specific changes in the G-DRG system, as well as in the classification systems for diagnoses and procedures and in invoicing for 2008. Since the G-DRG system is only a tool for the redistribution of resources, every hospital needs to analyze the economic effects of the system by applying the G-DRG transition grouper to its own cases.

[Changes for the field of rheumatology in the G-DRG-System 2007].

After extensive revision the partners of the self-administration"Selbstverwaltung" reached an amicable agreement on the new version 2007 of the G-DRG system. Like in the years before, version 2007 brings about large-scale changes for its users. A better representation of inpatient services in Germany combined with an improved economic homogeneity and appropriateness can be assumed.

[Discomfort and pain during mammography].

Introduction: Mammography is the most important method for early detection of breast cancer, however, patients frequently complain of discomfort and pain.

Objective: Evaluate how often discomfort and pain are felt during mammography and identify factors that may be associated to these complaints.

Methods: A prospective study including 2,164 patients recruited from public (996) and private (1,168) health services was carried out.

[What changes for rheumatologists in the G-DRG system 2006?].

Once more, the revision of the German DRG catalogue 2006 provides for more accurate reimbursement, particularly for specialised medical services. The newly established DRG I97Z (Rheumatologische Komplexbehandlung bei Krankheiten und Störungen an Muskel-Skelett-System und Bindegewebe) for the complex and multimodal treatment of rheumatic diseases allows an accurate picture of clinical practice in specialized rheumatologic departments and hospitals. Using this specific DRG-description, it will be possible to reduce the financial pressure which results from the redistribution of budgets in the second year of the period of convergence.

[Increasingly appropriate depiction of rheumatology for G-DRG reimbursement 2006].

Starting with the second year of the so called "convergence period", specialized rheumatological treatment is now represented by a specific DRG (197Z) in the German G-DRG system. The definition of this DRG is based on the procedure codes for the complex and multimodal treatment of rheumatological inpatients (OPS 8-983 and 8-986). This will result in a more appropriate reimbursement of rheumatological treatment.