[Effects of D-DRG system on hospital financing on the example of septorhinoplasty]

Since the introduction of DRGs (diagnosis related groups) 2004, the septorhinoplasty, regardless whether an open or closed approach is chosen or whether orthotopic cartilage or autologous cartilage is required and whether a complex deformity (patients with cleft palate) or post-traumatic deformities are treated in the adult all procedures are valued the same. The aim of the study was to investigate at a center for rhino-surgery the real effort for the different diseases and to assess the necessity of a new split in the DRG for septorhinoplasty.

Retrospective study of all patients, who were treated from January 2006 to December 2009 at the ENT Clinic of the University of Ulm with a septorhinoplasty/septal perforation closure in terms of duration of surgery and the material consumption.

In the years 2006-2009 at the ENT Clinic in Ulm 705 septorhinoplasties were performed, 124 were revision surgeries, 216 with ear cartilage and 35 with rib cartilage. In 66 cases nasal deformities due to cleft palate was treated. The duration of surgery of the different septorhinoplasties differed statistically significant from each other, also the material consumption/material costs.

A re-organization of the DRG D 37 can be justified with varying surgery time and material consumption for each operation type. A proposal is presented.