Gesundheitsökonomischer Vergleich von onkologischen und COVID-19-Patienten

Zusammenfassung

Zielsetzung Ziel der Studie ist es die Auswirkungen der COVID-19 Pandemie auf die stationär behandelten Patienten eines universitären Maximalversorgers mit einer Krebs- und/oder COVID-19-Erkrankung zu untersuchen. Unterscheiden sich die Patientenkollektive gesundheitsökonomisch und ergeben sich aus den Resultaten administrative Konsequenzen für eine proaktive Steuerung der regionalen Krebsversorgung.

Methodik Es wurde eine retrospektive, deskriptive Datenanalyse klinischer und gesundheitsökonomischer Parameter aller am Universitätsklinikum Marburg stationär aufgenommenen onkologischen und COVID-19-postiven Patienten sowie der Kombination von onkologischen Patienten mit einer COVID-19-Erkrankung innerhalb des Beobachtungszeitraums von 2017 bis 2021 durchgeführt.

Ergebnisse Es wurde ein Rückgang onkologisch behandelter Patienten über den gesamten Zeitraum der COVID-19-Pandemie beobachtet. Onkologische Patienten mit einer COVID-19-Erkrankung stellen das Patientenkollektiv mit dem höchsten Schweregrad der Erkrankung dar, gefolgt von der COVID-19- und rein onkologischen Patienten. Dies spiegelt sich gleichsam in den ökonomischen Leistungskennzahlen wider. Die chronologischen Verläufe des DRG-Erlöses und Case Mix Index pro COVID-19-Patienten weisen Unterschiede für Zeitabschnitte des Pandemiegeschehens in Deutschland auf.

Schlussfolgerung Der Vergleich der Patientenkollektive bestätigt das hohes Gefährdungspotential von onkologischen Patienten, welches sich in einer gesundheitsökonomisch aufwendigen Behandlung widerspiegelt. Nationale Maßnahmen, Kontaktbeschränkungen oder pandemische Ereignisse lassen sich am chronologischen Verlauf der klinischen und wirtschaftlichen Parameter nachvollziehen. Trotz des internationalen Rückgangs an ambulanten und stationären onkologischen Patienten ist die „state-of-the-art“ Krebsversorgung in pandemischen Zeiten realisierbar. Aufgrund dessen besteht die Handlungsnotwendigkeit für einen stationären Maximalversorger durch Kommunikation und Versorgungsmodellierung die onkologische Versorgung proaktiver zu steuern.

Abstract

Aim This study examines the impact of the COVID-19 pandemic on hospitalized patients with cancer and/or COVID-19 disease at a university-based maximum care provider. Do the patient collectives differ in terms of health economics and do the results yield administrative implications for proactive management of regional cancer care.

Method A retrospective, descriptive data analysis of clinical and health economic parameters of all oncological and COVID-19-postive patients admitted as in-patients at Marburg University Hospital and the combination of oncological patients with COVID-19 disease within the observation period from 2017 to 2021 was performed.

Results A decrease in oncology-treated patients was observed throughout the COVID-19 pandemic period. Oncology patients with COVID-19 disease represent the patient population with the highest severity of disease, followed by COVID-19 and oncology-only patients. This is reflected in the economic performance measures. The chronological progression of DRG revenue and Case Mix Index per COVID-19 patient shows differences for time periods of the pandemic in Germany.

Conclusion The comparison of the patient collectives confirms the particularly high-risk potential of oncological patients, which is reflected in a health economic costly treatment. National measures, contact restrictions or pandemic events can be traced by the chronological progression of clinical and economic parameters. Despite the international decline in out-patient and in-patient oncological patients, “state-of-the-art” cancer care is feasible in pandemic times. Because of this, there is a need for action for an inpatient maximum care provider to manage oncology care more proactively through communication and care modeling.

Schlüsselwörter

Onkologie - COVID-19 - Maximalversorger - Gesundheitsökonomie - Versorgungsforschung

Key words

oncology - COVID-19 - maximum care provider - health economics - health services research

Publication History

Article published online:
09 November 2022

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