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DOI: 10.1055/s-2007-963754
© Georg Thieme Verlag KG Stuttgart · New York
Benchmarking in der gastroenterologischen Endoskopie
Benchmarking in Gastrointestinal EndoscopyPublication History
Manuskript eingetroffen: 27.5.2005
Manuskript akzeptiert: 20.11.2007
Publication Date:
13 December 2007 (online)

Zusammenfassung
Qualität und Kosten endoskopischer Prozeduren in der Gastroenterologie haben in den letzten Jahren zunehmend Interesse bei den beteiligten medizinischen Professionen, Kostenträgern und Patienten gefunden. Mit dem Projekt „Benchmarking in der gastroenterologischen Endoskopie 2001/2003” wurde erstmalig ein externes Qualitätssicherungsverfahren unter gleichzeitiger Erfassung der Kosten endoskopischer Prozeduren realisiert. 9400 Untersuchungen aus 14 Abteilungen wurden analysiert. Präsentiert werden erste, besonders auffällige Beobachtungen: Das maschinenlesbare Erfassungsinstrument wurde korrekt benutzt (95 % Ausfüllquote der Pflichtfelder); die Kosten einer Endoskopie differierten zwischen den Abteilungen um das Zweifache bei diagnostischen Gastroskopien und bis zum Fünffachen bei therapeutischen ERCPs; in einzelnen Abteilungen wurde bei fast jeder zweiten elektiv-diagnostischen Koloskopie ein Polyp/Adenom nachgewiesen, in anderen nur bei jeder zehnten; Überwachungsverfahren wie die Pulsoxymetrie wurden z. T. nur bei jedem zweiten Patienten angewandt. Die Interpretation der Daten bedarf der Validierung in einer Projektfortsetzung mit größeren Untersuchungszahlen aus mehr Abteilungen.
Abstract
Quality and costs of endoscopic procedures in gastroenterology have recently come into focus of professionals and patients alike. The project presented here combines benchmarking of indicators of quality and simultaneous assessment of costs in departments of endoscopy. In all 9400 examinations from 14 departments were analysed. First and most obvious results are presented: the machine-readable data sheet was filled out correctly in 95 % (compulsory data fields); endoscopy costs differed by factor two for diagnostic gastroscopy and by factor five for therapeutic ERCP; in some departments a polypectomy was performed in up to every second diagnostic colonoscopy while in others polypectomy occurred only in 10 % in some departments patient monitoring like pulse oxymetry was used only in half of the procedures. Interpretation of the data requires further validation by resumption of the project to obtain more data from possibly more departments.
Schlüsselwörter
Benchmarking - gastroenterologische Endoskopie - Prozessanalyse - Prozesskosten - Qualitätssicherung - Qualitätsindikator
Key words
benchmarking - gastroenterological endoscopy - process analysis - process costs - quality assurance - quality indicators
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Dr. Ulrich Rosien
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