[Economic aspects of inpatient treatment for decompensated liver cirrhosis: a prospective study employing an evidence-based clinical pathway].

The introduction of the G-DRG reimbursement system has greatly increased the pressure to provide cost effective treatment in German hospitals. Reimbursement based on diagnosis-related groups, which requires stratification of costs incurred is still not sufficiently discriminating the disease severity and severity in relation to the intensive costs in gastroenterology. In a combined retrospective and prospective study at a tertial referral centre we investigated whether this also applies for decompensated liver cirrhosis.

[Realisation of material costs in anaesthesia. Alternatives to the reimbursement via diagnosis-related groups].

Background And Goal: For reimbursement via diagnosis-related groups (DRG), lump compensation-based payment of medical cases in German hospitals requires a case-related measuring and billing of resources that has to be consistent with DRG guidelines. Only through this, can the real costs be compared with the standard costs as calculated by the hospital reimbursment system (InEK) on a case-related basis and the DRG-specific break-even level be identified.

Methods: In the present paper the authors introduce and validate two newly created alternative methods for case-related allocation of material costs in the field of anaesthesia.

[Implementation of an internal transfer pricing system for anaesthesia services].

Internal transfer pricing system (ITPS) of anaesthesia services is established to guarantee a close connection of delivered service and the budget of the department of anaesthesia. In most cases a time-based system is used with the pricing unit being calculated as the quotient from the enumerator "costs" divided by the denominator "anaesthesia time in minutes". The implementation of a transfer pricing system requires the identification of all relevant costs caused by the department of anaesthesia and a cost centre structure is needed which allocates all costs correctly according to their cause.

Cholestasis as a side effect of bupivacaine?

Background And Objectives: Cholestasis has been proposed as a side effect of interpleural bupivacaine. Therefore, the effects of various application techniques on liver enzymes were studied following ethics committee approval and informed patient consent.

Methods: Patients following scheduled thoracotomy and laparoscopic cholecystectomy were prospectively studied and randomized to the following application techniques of bupivacaine: Thoracic surgery.

Intraperitoneal application of bupivacaine during laparoscopic cholecystectomy--risk or benefit?

We investigated, in a double-blind study, the effects of intraperitoneal local anesthetics during laparoscopic cholecystectomy. In Part A of the study 30 patients received 50 mL saline 0.9% (A 0), bupivacaine 0.