Erfahrung des Operateurs als Einflussfaktor auf die Operationsdauer am Beispiel ausgewählter unfallchirurgischer und orthopädischer Eingriffe an einer Universitätsklinik

by Jantje Bohlmann
Doctoral thesis
Date of Examination:2022-05-05
Date of issue:2022-06-03
Advisor:Prof. Dr. Stephan Sehmisch
Referee:Prof. Dr. Stephan Sehmisch
Referee:Dr. Reiner M. Waeschle
Persistent Address: http://dx.doi.org/10.53846/goediss-9228

 

 

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Abstract

English

In healthcare, cost-effectiveness plays an increasingly important role, at least since the introduction of the Diagnosis Related Groups (DRG) system. Meanwhile, the training and further education of residents gets more important, not least because of the increasing shortage of physicians. In this area of conflict, this study project at a university hospital examined whether the experience of the surgeon can influence the duration of an operation. For this purpose, the incision-suture times of less experienced surgeons were compared with those of experienced surgeons in the field of endoprosthetics, material removal and osteosynthesis for up to 1,500 operations. In endoprosthetics, the incision-suture times of the less experienced surgeons were longer on average than those of experienced colleagues. Similar could be shown for the removal of osteosynthesis material. For osteosynthesis treatment, on the other hand, it took less time for less experienced physicians than more experienced colleagues, but more than senior surgeons (with private liquidation). The study shows differences in the individual patient collectives as a possible reason for this. The patients of the less experienced physicians showed a lower "Patient Comorbidity and Compliation Level" (PCCL). The results of this study should serve a well-founded exchange in a field of tension between medical and economic perspectives, the jointly declared goal of which should be the sustainable health care of society.
Keywords: OPS; residents; OPS code; DRG; duration of operation; incision time; suture time; incision-suture time; experience surgeon; PCCL; resident training; patient comorbidity and complication level; physicians
Schlagwörter: OPS; OPS-Code; Kodierung; Operationsdauer; Schnitt-Naht-Zeit; Dauer Operation; Erfahrung Operateur; Weiterbildung; PCCL; patient comorbidity and complication level
 
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