[Trends in uro-oncological surgery in Germany-comparative analyses from population-based data].
C Groeben1, R Koch2, M Baunacke2
1Klinik und Poliklinik für Urologie, Medizinische Fakultät, Universitätsklinikum, Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland. christer.groeben@uniklinikum-dresden.de.
Der Urologe. Ausg. A
|September 7, 2021
Summary
Higher hospital case volume for urologic cancer surgeries correlates with better patient outcomes. Despite this, there
Area of Science:
- Urology
- Oncology
- Health Services Research
Background:
- Urologic cancer presents a significant health economic burden in Germany.
- Limited understanding of uro-oncological intervention structures and development in German surgical hospitals.
Purpose of the Study:
- To analyze trends in major uro-oncological surgeries in Germany.
- To investigate the impact of technical innovations and guideline changes on case numbers.
- To examine the relationship between hospital case volume and perioperative outcomes.
Main Methods:
- Utilized the diagnosis-related group (DRG) database from the Federal Statistical Office.
- Analyzed 5 major uro-oncological procedures (prostatectomy, cystectomy, renal tumor surgery, retroperitoneal lymphadenectomy, penis surgery) from 2006-2013/2016.
- Correlated annual case numbers with perioperative outcomes.
Main Results:
- A clear correlation exists between hospital case volume (expertise) and improved perioperative outcomes.
- No significant trend towards centralization of uro-oncological interventions observed.
- Case number development appears influenced by technical innovation marketing and patient-clinic regional ties.
- Past attempts at centralizing case numbers or voluntary certifications had minimal impact.
Conclusions:
- Hospital expertise, indicated by case volume, is crucial for better uro-oncological surgical outcomes.
- Current uro-oncological intervention distribution lacks centralization despite evidence favoring high-volume centers.
- Future strategies may need to consider factors beyond centralized control to improve uro-oncological care delivery.
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