Comparison Of Drg Revenues Between Fast And Slow-Track Procedures For A Two-Stage Replacement Of Prostheses For Periprosthetic Hip Infections In The Ag-Drg System 2020

Background The treatment of periprosthetic hip infections is usually cost intensive, so it is generally not cost effective for hospitals. In chronic infections, a two-stage procedure is often indicated, which can be done as a fast-track procedure with a short prosthetic-free interim interval (2-4 weeks) or as a slow-track procedure with a long prosthetic-free interim interval (over 4 weeks). Aim The aim of this study was to elucidate the revenue situation of both forms of treatment in the aG-DRG-System 2020, taking into account revenue-relevant influencing factors. Methods For fast-track and slow-track procedures with two-stage revision and detection of a staphylococcus aureus (MSSA), treatment cases were simulated using a grouper software (3M KODIP Suite) based on the diagnoses (ICD-10-GM) and procedures (OPS) and then grouped into DRGs. Revenue-relevant parameters, such as length of stay and secondary diagnoses (SD), were taken into account. In addition, two real treatment cases with fast-track and slow-track procedures were compared to each other. Results The total revenues for the slow-track procedure with a length of stay of 25 days (without SD) were 27,551 euro and for a length of stay of 42 days (with SD) even 40,699 euro, compared to 23,965 euro with the fast-track procedure with a length of stay of 25 days (without SD) and 27,283 euro for a length of stay of 42 days (with SD). The real treatment cases also showed a big difference in the total revenues of 12,244 euro in favor of the slow-track procedure. Discussion Even in the aG-DRG-System 2020, the two-stage revision procedure with a long interim interval seems to be more interesting from a financial point of view and the hospital perspective compared to the fast-track procedure, especially with multimorbid patients. This creates a financial barrier to the treatment of such patients with a short interim interval.