Het volume van chirurgische ingrepen en de impact ervan op ... - KCE

More documents

Recommendations

Info

142 Volume Outcome KCE reports 113 6.2.3 Definition of procedure A total of 169 stays are excluded because of congenital anomalies (Table 6.11). Table 6.11: CABG with/without heart valve replacement or repair: Exclusion of congenital anomalies Number Percent 745 Bulbus cordis anomalies and anomalies of cardiac septal closure 30 17.75 746 Other congenital anomalies of heart 129 76.33 747 Other congenital anomalies of circulatory system 8 4.73 759 Other and unspecified congenital anomalies 2 1.18 total 169 Ninety-eight per cent of the stays (Number = 10 697) are classified in MDC 05 circulatory system. The remaining 2% (Number = 265) are excluded from selection. As shown in Table 6.12, majority of the selected stays (99%) are in the APR-DRG CABG (165, 166) or in the APR-DRG cardiac valve (162, 163). Since there is no specific APR-DRG for the combination of the two procedures, the selection has to be made based on the NIHDI procedure code. Table 6.12: CABG with/without heart valve replacement or repair: All APR- DRG from MDC 05 APR-DRG Number Percent 166-CORONARY BYPASS W/O MALFUNCTIONING CORONARY BYPASS W/O CARDIAC CATH / 5 – P 4482 41.90 165-CORONARY BYPASS W/O MALFUNCTIONING CORONARY BYPASS W CARDIAC CATH / 5 - P 2641 24.69 163-CARDIAC VALVE PROCEDURES W/O CARDIAC 2577 24.09 CATHETERIZATION / 5 - P 162-CARDIAC VALVE PROCEDURES W CARDIAC 848 7.93 CATHETERIZATION / 5 – P 167-OTHER CARDIOTHORACIC PROCEDURES / 5 – P 76 0.71 161-CARDIAC DEFIBRILLATOR IMPLANT / 5 – P 29 0.27 168-MAJOR THORACIC VASCULAR PROCEDURES / 5 – P 18 0.17 160-MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY / 5 – P 8 0.07 173-OTHER VASCULAR PROCEDURES / 5 – P 5 0.05 174-PERCUTANEOUS CARDIOVASCULAR PROCEDURES W AMI / 5 – P 3 0.03 177-CARDIAC PACEMAKER & DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT / 5 – P 3 0.03 171-PERM CARDIAC PACEMAKER IMPLANT W/O AMI, HEART FAILURE OR SHOCK / 5 – P 2 0.02 175-PERCUTANEOUS CARDIOVASCULAR PROCEDURES W/O AMI / 5 – P 2 0.02 180-OTHER CIRCULATORY SYSTEM PROCEDURES / 5 – P 2 0.02 164-CORONARY BYPASS W MALFUNCTIONING CORONARY BYPASS GRAFT / 5 - P 1 0.01 total 10697 100.00 Because of differences in outcomes, the KCE expert group proposed to create three intervention categories: 1. Isolated CABG Selection based on NIHDI codes 229585, 229622 and 229644 (see Table 6.10 for description of codes). Because of lack of information in the NIHDI codes, it is not possible to make a distinction between on and off pump CABG. 2. Isolated heart valve replacement or repair Selection based on NIHDI code 229600 (see Table 6.10). This intervention involves valve repair or valve replacement only. 3. Combination of CABG and heart valve Selection based on code 229526 (see Table 6.10). This intervention involves valve replacement associated with a CABG.
KCE Reports 113 Volume Outcome 143 Table 6.13 shows the repartition of all CABG with/without heart valve repair or replacement in these three intervention categories. In addition, the database contained 17 stays with other combinations of these codes. These stays were excluded from the selection since two different interventions were probably performed during the same stay. Table 6.13: CABG with/without heart valve replacement or repair: Repartition in three intervention categories Number Percent Isolated CABG 6813 63.79 Isolated heart valve replacement or repair 1868 17.49 Combination of CABG and heart valve 1655 15.50 no NIHDI code 344 3.22 total 10 680 Table 6.13 shows that for 344 of the selected stays (3.2%), none of the selected NIHDI codes was present in the database. These stays were subsequently classified in one of three intervention categories on the basis of their APR-DRG which are listed in Table 6.14. Table 6.14: CABG with/without heart valve replacement or repair: APR- DRGs from 344 stays without NIHDI code APR-DRG Number Percent 160-MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY / 5 - P 1 0.29 162-CARDIAC VALVE PROCEDURES W CARDIAC CATHETERIZATION / 5 - P 24 6.98 163-CARDIAC VALVE PROCEDURES W/O CARDIAC CATHETERIZATION / 5 - P 61 17.73 165-CORONARY BYPASS W/O MALFUNCTIONING CORONARY 126 36.63 BYPASS W CARDIAC CATH / 5 - P 166-CORONARY BYPASS W/O MALFUNCTIONING CORONARY BYPASS W/O CARDIAC CATH / 5 - P total 344 132 38.37 Finally, this resulted in 10 679 stays. The final repartition of these CABGs with/without heart valve repair or replacement in the three intervention categories is shown in Figure 4.1. Figure 6.8: Final selection of stays with CABG and/or heart valve repair or replacement Results of procedure definition for CABG, valvuloplasty or their combination: 10 679 stays selected of which: - isolated CABG : 7 071 stays; - CABG combined with heart valve replacement/repair : 1 655 stays; - isolated heart valve replacement/repair: 1 953 stays.
Page 1 and 2:
Het volume van chirurgische ingrepe
Page 3 and 4:
Het volume van chirurgische ingrepe
Page 5 and 6:
KCE reports 113A Volume - Uitkomst
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18:
KCE Reports 113 Volume Outcome 1 Sc
Page 19 and 20:
KCE Reports 113 Volume Outcome 3 6.
Page 21 and 22:
KCE Reports 113 Volume Outcome 5 Ab
Page 23 and 24:
KCE Reports 113 Volume Outcome 7 2
Page 25 and 26:
KCE Reports 113 Volume Outcome 9 5.
Page 27 and 28:
KCE Reports 113 Volume Outcome 11 O
Page 29 and 30:
KCE Reports 113 Volume Outcome 13 F
Page 31 and 32:
KCE Reports 113 Volume Outcome 15 T
Page 33 and 34:
KCE Reports 113 Volume Outcome 17 P
Page 35 and 36:
Page 37 and 38:
Page 39 and 40:
Page 41 and 42:
Page 43 and 44:
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
KCE Reports 113 Volume Outcome 33 H
Page 51 and 52:
Page 53 and 54:
Page 55 and 56:
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
Page 63 and 64:
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
Page 71 and 72:
Page 73 and 74:
KCE Reports 113 Volume Outcome 57 R
Page 75 and 76:
Page 77 and 78:
KCE Reports 113 Volume Outcome 61 C
Page 79 and 80:
KCE Reports 113 Volume Outcome 63 A
Page 81 and 82:
Page 83 and 84:
Page 85 and 86:
Page 87 and 88:
Page 89 and 90:
Page 91 and 92:
Page 93 and 94:
KCE Reports 113 Volume Outcome 77 D
Page 95 and 96:
Page 97 and 98:
Page 99 and 100:
Page 101 and 102:
Page 103 and 104:
Page 105 and 106:
Page 107 and 108: KCE Reports 113 Volume Outcome 91 F
Page 109 and 110: KCE Reports 113 Volume Outcome 93 R
Page 111 and 112: KCE Reports 113 Volume Outcome 95 T
Page 113 and 114: KCE Reports 113 Volume Outcome 97 V
Page 115 and 116: KCE Reports 113 Volume Outcome 99 5
Page 117 and 118: KCE Reports 113 Volume Outcome 101
Page 157: KCE Reports 113 Volume Outcome 141
Page 209 and 210:
KCE Reports 113 Volume Outcome 193
Page 211 and 212:
Page 213 and 214:
Page 215 and 216:
Page 217 and 218:
Page 219 and 220:
Page 221 and 222:
Page 223 and 224:
Page 225 and 226:
Page 227 and 228:
Page 229 and 230:
Page 231 and 232:
Page 233 and 234:
Page 235 and 236:
Page 237 and 238:
Page 239 and 240:
Page 241 and 242:
Page 243 and 244:
Page 245 and 246:
Page 247 and 248:
Page 249 and 250:
Page 251 and 252:
Page 253 and 254:
This page is left intentionally bla
Page 255 and 256:
KCE reports 1. Effectiviteit en kos
Page 257 and 258:
73. Financiering van het zorgprogra
show all

Het volume van chirurgische ingrepen en de impact ervan op ... - KCE

Create successful ePaper yourself

Delete template?

Save as template?