Treatment costs for anterior cruciate ligament reconstruction: procedure related cost analysis in an university hospital]

Complex procedures in knee surgery, such as anterior cruciate ligament (ACL) reconstruction with the double bundle technique are not specially recognized within the German diagnosis-related groups (G-DRG) system. Hence, the goal of the present study was to perform a cost unit calculation and evaluate how ACL reconstruction in single versus double bundle techniques is remunerated. In 30 patients ACL reconstruction was performed with the single bundle technique (group A) and in 21 an anatomic double bundle reconstruction (group B) was performed. All costs including those for human resources, implants and materials, as well as general costs for administration and facilities were calculated. All cases entered one DRG category, the I30Z"complex procedures at the knee joint". Thus, the revenue in 2008 was 2,996.65 a,not sign per case and in 2009 3,120.35 a,not sign per case. Calculating all costs, the profit contributions in 2008 and 2009 were 592,42 a,not sign and 716,12 a,not sign, respectively for group A. However, in group B the profit contributions were 314,68 a,not sign and 438,38 a,not sign, respectively. Performing the double bundle technique for ACL reconstruction in a university hospital setting, significant cost reductions are needed to achieve the revenue generated by the single bundle technique. Additional changes of the relative weighting in the DRG are also necessary.