Can We Still Afford Innovative Surgical Procedures?

Author:

Lux Michael Patrick12,Untch Michael3,Kolberg Hans-Christian4,Friedrich Michael5,Thill Marc6,Schütz Florian7

Affiliation:

1. Frauenklinik St. Louise, St. Vincenz-Krankenhaus GmbH, Klinik für Gynäkologie und Geburtshilfe, Paderborn, Deutschland

2. St. Josefs-Krankenhaus, St. Vincenz-Krankenhaus GmbH, Klinik für Gynäkologie und Geburtshilfe, Salzkotten, Deutschland

3. Interdisziplinäres Brustzentrum, Helios Klinikum Berlin Buch, Klinik für Gynäkologie und Geburtshilfe, Berlin, Deutschland

4. Klinik für Gynäkologie und Geburtshilfe, Marienhospital Bottrop gGmbH, Bottrop, Deutschland

5. Klinik für Frauenheilkunde und Geburtshilfe, HELIOS Klinikum Krefeld, Krefeld, Deutschland

6. Klinik für Gynäkologie und Gynäkologische Onkologie, Agaplesion Markus Krankenhaus, Frankfurt am Main, Deutschland

7. Klinik für Gynäkologie und Geburtshilfe, Diakonissen-Stiftungs-Krankenhaus Speyer, Speyer, Deutschland

Abstract

Abstract Introduction Hospitals are currently facing major financial challenges. Due to the high incidence of breast cancer and the complex range of associated services, surgical treatment of breast cancer is a particular case in point when it comes to the question of cost coverage for innovative versus established procedures by the service providers. The aim of this study is to shed light from a healthcare economics perspective on the current situation of hospitals in Germany with regard to their different structures and processes for breast-conserving therapy. Materials and methods An online questionnaire with 46 questions was developed and made available to hospitals that are members of the AGO [German Working Group for Gynecological Oncology] Breast Committee and AWOgyn [German Working Group for Cosmetic, Plastic and Reconstructive Surgery in Gynecology], as well as AG-certified breast centers. The questions cover various parameters for health economics analysis, including primary case numbers, structures, and questions about tumor and sentinel marking and surgical procedures. Results 142 hospitals or breast centers took part in the survey. 93% of the hospitals were certified. The average number of primary cases was 264.6 per year. In over 60% of the hospitals, the surgical procedure and surgery planning were influenced by capacity limitations of cooperation partners. “Targeted axillary dissection” was performed in 83.5% of the hospitals, and radioactive markers were most commonly used for sentinel lymph node marking. Over 60% of participating hospitals were highly satisfied with the marking method used. Conclusion This structure and process analysis now makes it possible to reflect on the costs involved for hospitals of different sizes, in different regions, and with different funding models, and to use this as a basis for the economic evaluation of new surgical procedures within an overall context. In general, it is possible to make savings through innovative procedures in the surgical treatment of breast cancer.

Publisher

Georg Thieme Verlag KG

Subject

General Earth and Planetary Sciences,General Environmental Science

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