[Implementation of new technologies in the DRG system under economic aspects]

The implementation of technological innovations in surgery, such as robotic-assisted procedures, novel implants, navigation or modern visualization techniques, pose an economic challenge for institutions, as they are rarely cost-covering per se. In the German diagnosis-related groups (DRG) system, the costs of numerous novel technologies and innovations in surgery are not or not sufficiently covered in the short term and even less in the middle and long term. This review article describes the economic aspects of surgical innovations and outlines possible ways for hospitals to cover costs. A simulated case study illustrates the extent to which the current German DRG tariff system reflects the costs of minimally invasive techniques (laparoscopic, robot-assisted) in the context of an elective sigmoid colon resection with benign indications.