Urologie最新文献

{"title":"[How will hybrid-DRGs (diagnosis related groups) change German urology? : A survey and potential analysis].","authors":"Philipp Reimold, Christer Groeben, Angelika Borkowetz, Nicole Eisenmenger, Frank König, Marianne Leitsmann, Ulrich Witzsch, Markus Müller, Markus Schöne, Daniela Schultz-Lampel, Margit Fisch, Peter Kollenbach, Andreas Schneider, Jens Westphal, Holger Borchers, Axel Belusa, Maurice Stephan Michel, Björn Volkmer, Johannes Huber","doi":"10.1007/s00120-024-02515-z","DOIUrl":"10.1007/s00120-024-02515-z","url":null,"abstract":"<p><strong>Background: </strong>The introduction of hybrid DRGs on 1 January 2024 is intended to create incentives to perform inpatient urology services, e.g., ureterorenoscopy (URS), on an outpatient basis. The effects on the reality of care are currently unclear.</p><p><strong>Objectives: </strong>The aim of the survey was to gather an opinion on the introduction of hybrid DRGs in urology and to analyze initial practical experiences and future prospects.</p><p><strong>Materials and methods: </strong>In a Germany-wide online survey conducted between May and July 2024, 32 questions were asked about patient care, further training and other indications, among other things. In addition, an assessment of the outpatient potential for URS for ureteral and kidney stones and hydrocele resections was requested.</p><p><strong>Results: </strong>A total of 364 urologists responded to the survey: 54.5% were in private practice and 45.5% worked in hospitals. 91.1% were active surgeons. The concept of hybrid DRGs was rated positively by 34% of those working in surgery, but 68% saw no relief in their everyday work. 51% expressed concerns about the negative impact on further training. The proportion of URS performed on an outpatient basis in 2023 was 21% (ureteral stones) and 11% (kidney stones), with a long-term potential increase of up to 33%. Two thirds of hydrocele resections were already performed on an outpatient basis, and 74% of respondents considered these to be billable in a hybrid DRG.</p><p><strong>Conclusion: </strong>The survey shows a differentiated opinion on hybrid DRGs in urology, but the sample only comprises around 6% of urologists in Germany. It would make sense to repeat the survey at a later date in order to evaluate developments in practical use.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"453-461"},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Relief of bladder outlet obstruction and improvement of symptoms following drug therapy vs. surgery for lower urinary tract symptoms indicative of benign prostatic hyperplasia: a systematic review].","authors":"Lukas Koneval, Karl Georg Sommer, Laila Schneidewind","doi":"10.1007/s00120-025-02572-y","DOIUrl":"10.1007/s00120-025-02572-y","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"479-482"},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Benign prostate syndrome].","authors":"Thomas Bschleipfer","doi":"10.1007/s00120-025-02560-2","DOIUrl":"10.1007/s00120-025-02560-2","url":null,"abstract":"<p><p>If variable bladder storage and/or voiding symptoms occur due to or in combination with a benign enlargement of the prostate, together with various etiological, pathological and pathophysiological changes in the lower urinary tract, this is referred as benign prostate syndrome. Comprehensive diagnostics are essential in order to provide treatment that is appropriate to the symptoms and the patient's level of suffering. If differential diagnostic diseases can be ruled out, conservative and medicinal treatment approaches, such as watchful waiting, phytotherapy or various synthetic chemical preparations as well as surgical procedures, such as transurethral techniques, suprapubic adenoma enucleation (simple prostatectomy) and prostate artery embolization are available for patients.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"492-500"},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BvDU Kurz notiert.","authors":"","doi":"10.1007/s00120-025-02587-5","DOIUrl":"https://doi.org/10.1007/s00120-025-02587-5","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":"64 5","pages":"506-510"},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[On the legal permissibility of urological emergency services with nonspecialist assistants : Statement by the legal counsel of the German Society of Urology].","authors":"Thomas Willaschek, Sebo-Franz Krubally","doi":"10.1007/s00120-025-02575-9","DOIUrl":"https://doi.org/10.1007/s00120-025-02575-9","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":"64 5","pages":"483-486"},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The sexual revolution and the rise of urologists in Germany].","authors":"Florian G Mildenberger","doi":"10.1007/s00120-025-02549-x","DOIUrl":"10.1007/s00120-025-02549-x","url":null,"abstract":"<p><p>The sexual revolution of the 1960s is not generally associated with urology. However, the general availability of sexual services combined with the lack of expertise of general practitioners to deal with this and the changed social conditions led to urologists once again becoming the \"masters of the genital area\". This reopened a discourse that had been interrupted in 1933. Today, urologists have long since replaced GPs as the primary point of contact, diagnosticians and therapists for men's health issues.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"469-475"},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Outpatient care in urology-an economic impact assessment].","authors":"Daniela Roschütz, Jens-Uwe Stolzenburg, Nikolaus von Dercks","doi":"10.1007/s00120-025-02552-2","DOIUrl":"10.1007/s00120-025-02552-2","url":null,"abstract":"<p><strong>Background: </strong>The expansion of the AOP (ambulatory operation procedure) catalog according to § 115 b SGB V in the years 2023 and 2024, as well as the introduction of hybrid-DRGs (disease-related groups) according to § 115 f SGB V, poses significant planning challenges for clinics. These regulatory changes are accompanied by significant financial uncertainties for clinics, thus, necessitating careful planning. The need to treat patients in an outpatient setting forces hospitals to adjust their operational processes. The aim of this study is to analyze the impact on revenue in the urology department of a maximum care provider.</p><p><strong>Methods: </strong>Data selection is made from the entire dataset of the urology department from the year 2023, including all procedures from the AOP catalog, applying context verification. From this, three risk groups (RG) are formed: 1) all cases that remain after context verification but still contain other procedures than only AOP procedures, 2) cases that contain only AOP procedures, and 3) a RG of the hybrid-DRG. An analysis of individual epidemiological parameters and a cost simulation were carried out.</p><p><strong>Results: </strong>RG 1, with a share of 28.1% of the total number of cases, shows the greatest risk with 701 cases amounting to € 1,742,819 when treated in an outpatient setting. With 3.8%, RG 2 results in a significantly lower risk on revenue with 91 cases amounting to € 161,479 or € 106,071 after the cost-revenue simulation. RG 3 of the hybrid-DRG represents the lowest revenue risk with 24 cases amounting to € 10,880. The cost simulation shows a negative result for RG 3 accounting to € 18,925.</p><p><strong>Conclusion: </strong>Transferring inpatient operations of urological patients to outpatient treatment is associated with a decline in revenue in urology. RG 2 and 3 show certainly calculable declines in revenue. Hospitals must analyze the loss of revenue and develop solution strategies.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"462-468"},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Cross-sectoral urological training].","authors":"Quynh Chi Le, Jens Westphal, Axel Heidenreich, Max Tüllmann","doi":"10.1007/s00120-025-02570-0","DOIUrl":"10.1007/s00120-025-02570-0","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"447-452"},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The future of urological training: challenges, expectations, and innovations].","authors":"Frank Kunath, Axel Heidenreich","doi":"10.1007/s00120-025-02576-8","DOIUrl":"https://doi.org/10.1007/s00120-025-02576-8","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":"64 5","pages":"415-417"},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GeSRU.","authors":"","doi":"10.1007/s00120-025-02589-3","DOIUrl":"https://doi.org/10.1007/s00120-025-02589-3","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":"64 5","pages":"524-525"},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}