Die Kosten der Lipödem-Behandlung übersteigen den DRG-Erlös-Evaluation der operativen Behandlungskosten des Lipödems (Stadium III) an einer deutschen Universitätsklinik

Background Liposuction for stage III lipoedema is a guidelinebased but also time-consuming treatment, which can be carried out under specific conditions at the expense of the German statutory health insurance companies (SHI) based on a decision made by the German Federal Joint Committee ("Gemeinsamer Bundesausschuss", G-BA), the highest decision-making body in the German healthcare system, in 09/2019. We postulate that the treatment is not reflected in a cost-covering manner in the university cost system. Methods This monocentric, retrospective study examined the economic aspects of 92 cases in 48 lipoedema patients treated during the period from 09/2019 to 08/2023 at the expense of the SHI. These cases were filtered out using DRG coding and the Operation and Procedure Classification system ("Operationen-und Prozedurenschlössel", OPS), and the costs and revenues per patient were calculated using the data from our internal service accounting. Results After an inpatient stay of 2.64 ±a 1.33 days, the total revenue was 4,726.79 ±a 680.98. This included 1,532.92 ±a 856.99 inpatient costs, 2,686.02 ±a 1,174.70 in operating costs, 940.76 ±a 189.18 in anaesthesia costs and 63.19 ±a 125.38 in other costs that had to be paid within the clinic. On average across all treatments, this resulted in a loss of-875.22 /case. In 54 cases (59 %), the costs exceeded the revenue. In total, the calculation of all cases resulted in a loss of-80,520.63. If medical personnel costs are included, this amount rises to over 100,000. Conclusion The results show that the surgical treatment of lipoedema in the German DRG and university cost systems is not cost-covering. This could be relevant in the final economic assessment of the G-BA, which may result in an adjustment of the DRG revenue.