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The impact of post-procedural complications on reimbursement, length of stay and mechanical ventilation among patients undergoing transcatheter aortic valve implantation in Germany

Author

Listed:
  • Klaus Kaier

    (University of Freiburg
    Heart Center Freiburg University)

  • Holger Reinecke

    (University Hospital Muenster)

  • Huseyin Naci

    (London School of Economics and Political Science)

  • Lutz Frankenstein

    (University of Heidelberg)

  • Martin Bode

    (Heart Center Freiburg University
    Osnabrück University of Applied Sciences)

  • Werner Vach

    (University of Freiburg)

  • Philip Hehn

    (University of Freiburg)

  • Andreas Zirlik

    (Heart Center Freiburg University)

  • Manfred Zehender

    (Heart Center Freiburg University)

  • Jochen Reinöhl

    (Heart Center Freiburg University)

Abstract

Background The impact of various post-procedural complications after transcatheter aortic valve implantation (TAVI) on resource use and their consequences in the German reimbursement system has still not been properly quantified. Methods In a retrospective observational study, we use data from the German DRG statistic on patient characteristics and in-hospital outcomes of all isolated TAVI procedures in 2013 (N = 9147). The impact of post-procedural complications on reimbursement, length of stay and mechanical ventilation was analyzed using both unadjusted and risk-adjusted linear and logistic regression analyses. Results A total of 235 (2.57%) strokes, 583 (6.37%) bleeding events, 474 (5.18%) cases of acute kidney injury and 1428 (15.61%) pacemaker implantations were documented. The predicted reimbursement of an uncomplicated TAVI procedure was €33,272, and bleeding events were associated with highest additional reimbursement (€12,839, p 48 h: OR 6.93, p 48 h: OR 5.73, p

Suggested Citation

  • Klaus Kaier & Holger Reinecke & Huseyin Naci & Lutz Frankenstein & Martin Bode & Werner Vach & Philip Hehn & Andreas Zirlik & Manfred Zehender & Jochen Reinöhl, 2018. "The impact of post-procedural complications on reimbursement, length of stay and mechanical ventilation among patients undergoing transcatheter aortic valve implantation in Germany," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(2), pages 223-228, March.
    • Handle: RePEc:spr:eujhec:v:19:y:2018:i:2:d:10.1007_s10198-017-0877-7
    DOI: 10.1007/s10198-017-0877-7
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    References listed on IDEAS

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    1. Jonas Schreyögg & Oliver Tiemann & Reinhard Busse, 2006. "Cost accounting to determine prices: How well do prices reflect costs in the German DRG-system?," Health Care Management Science, Springer, vol. 9(3), pages 269-279, August.
    2. Matthias Vogl, 2012. "Assessing DRG cost accounting with respect to resource allocation and tariff calculation: the case of Germany," Health Economics Review, Springer, vol. 2(1), pages 1-12, December.
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    More about this item

    Keywords

    Post-procedural complications; TAVR; Transcatheter aortic valve replacement; Excess costs; Reimbursement; Resource use;
    All these keywords.

    JEL classification:

    • C01 - Mathematical and Quantitative Methods - - General - - - Econometrics
    • I10 - Health, Education, and Welfare - - Health - - - General

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