Abstract:
BACKGROUND:The introduction of the S3 guideline on "Sedation in Gastrointestinal Endoscopy" in 2008 led to substantial organisational, structural, staffing-related, financial, and legal changes in the everyday work of departments of gastrointestinal endoscopy. This study examines the economic effects of this and the change in the legal situation. In addition, the extent to which the guideline has been implemented was assessed using an electronic questionnaire circulated to the members of the Working Group of Head Gastroenterologists in Hospitals (ALGK). METHODS:The increased financial burden in the area of staff costs resulting from correct compliance with the sedation guideline was calculated using research figures from an endoscopy department in a maximum-care non-university hospital, dating from 2009. Interpretation of the legal implications of the guideline was provided by lawyers familiar with medical legislation. The question of the extent to which the guideline has been implemented in everyday clinical practice in endoscopy departments in 2011 was investigated using an evaluation questionnaire sent to the members of the ALGK. RESULTS:Implementation of the S3 sedation guideline leads to a substantial increase in the financial burden in the area of staff costs. Assuming 8000 in-patient endoscopy procedures, a conservative estimate indicates extra costs amounting to € 257 462.- per year (gross costs for the employer). The analysis of the questionnaire sent to ALGK members on the implementation of the S3 guideline 3 years after its publication showed that its major points, particularly the deployment of a third staff member for sedation, have not been acted on. CONCLUSIONS:The S3 guideline on "Sedation in Gastrointestinal Endoscopy" leads to a substantial increase in the financial burden in the area of staff costs by requiring the presence of a third person exclusively concerned with sedation. This recommendation was issued by the authors of the guideline without any evidence being available. In addition, it leads to a clear change in the legal situation, which in case of claims arising is associated with substantial implications for the physician responsible. The questionnaire evaluation among the members of the ALGK showed that the guideline has not so far been implemented in in-patient gastroenterology.
journal_name
Z Gastroenteroljournal_title
Zeitschrift fur Gastroenterologieauthors
Behrens A,Kainzinger FA,Nölling T,Wienke A,Pech O,Ell Cdoi
10.1055/s-0032-1313080subject
Has Abstractpub_date
2012-09-01 00:00:00pages
1002-7issue
9eissn
0044-2771issn
1439-7803journal_volume
50pub_type
杂志文章abstract::Diathermocoagulation is indispensable in interventional endoscopy. The argon beam coagulation represents an innovative electrocoagulation method, where high-frequency alternating current is conducted to tissues by ionized argon gas without contact. Before clinical application we performed in vitro studies to evaluate ...
journal_title:Zeitschrift fur Gastroenterologie
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更新日期:1995-12-01 00:00:00
abstract::Foreign bodies as a nucleus for precipitation of gall-stones are not frequently observed. The combination of primary immigrated foreign bodies into the bile ducts and following encasing by a gall-stone could be even more rarely found. A case report is presented concerning a patient, in whom a hemo-clip was fixed away ...
journal_title:Zeitschrift fur Gastroenterologie
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abstract::Chronic hepatitis C virus infection can be associated with mixed cryoglobulinemia and systemic vasculitis. The pathogenesis remains poorly understood. 55 consecutive patients with chronic HCI infection (anti-HCV- and serum HCV RNA-positive) were studies prospectively. Cryoglobulinemia was detected in 28 patients (51%)...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1995-11-01 00:00:00
abstract::In spite of modern diagnostic possibilities, the diagnosis of celiac disease is still challenging for the physician. This is due to the great variability of the clinical presentation. Nowadays, the classical symptoms like diarrhea, weight loss and abdominal pain are seen less often. It has become evident that celiac d...
journal_title:Zeitschrift fur Gastroenterologie
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abstract::Quantitative autoradiography was used to assess the densities of gamma-aminobutyric acid (GABAA) receptors in the brains of rats with a portacaval end-to-side shunt (PCA). The shunt alone induced only mild encephalopathy with ataxia and decreased locomotion. Aggravation of the encephalopathy was achieved by gavage fee...
journal_title:Zeitschrift fur Gastroenterologie
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doi:
更新日期:1990-03-01 00:00:00
abstract::Between 1981 and 1987 5434 patients were studied by ERCP in Allgemeines Krankenhaus Hamburg-Barmbeck. 26 (i.e. 0.43%) suffered from Mirizze syndrome with the triad of cholelithiasis, cholecystitis and obstructive biliary disease. They were classified in four different types according to the variable localisation and o...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1990-04-01 00:00:00
abstract::Indication and significance of roentgenological procedures referring to esophageal and gastric motility are discussed with special reference to a number of functional disorders. Cinematography and tape-recording are necessary for fast peristaltic motion as in vascular, neurological and myogenic diseases of the upper e...
journal_title:Zeitschrift fur Gastroenterologie
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更新日期:1977-03-01 00:00:00
abstract::Portal hypertension in patients with liver cirrhosis can be improved, not only by surgical or interventional shunt placements, but also by drug-only treatment. Many recent studies addressed the question whether any of these substances can improve survival of patients with liver cirrhosis when administered continuously...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
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journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:
更新日期:1997-03-01 00:00:00
abstract::Humoral and/or cell-mediated (CMI) immune responses to HBAg components, human and rabbit liver specific proteins (HLP and RLP) and tuberculin were tested in patients with acute virus B and non-B-hepatitis, asymptomatic HBsAg carriers and HBsAg positive chronic active hepatitis (CAH). Furthermore, the presence of HBsAg...
journal_title:Zeitschrift fur Gastroenterologie
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更新日期:1976-05-01 00:00:00
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journal_title:Zeitschrift fur Gastroenterologie
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doi:
更新日期:1990-06-01 00:00:00
abstract::Various sorbents were tested in-vitro for their ability to support hepatic excretory and detoxification functions, and their in-vivo perfusion with plasma was studied in an animal experiment. Amino acids, particularly phenylalanine and tyrosine, were strongest bound by activated charcoal, while Amberlite XAD-7 removed...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1979-02-01 00:00:00
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journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
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journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:
更新日期:1990-05-01 00:00:00
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journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract::The major target antigen of LKM-1 autoantibodies in chronic active hepatitis is cytochrome P450 IID6. The role of LKM-1 autoantibodies in the pathogenesis of the disease is not clear. A crucial point is the expression of the target epitope on the hepatocyte membrane. Cultured rat hepatocytes were used in this study. T...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1993-04-01 00:00:00
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journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
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abstract::Our case report on a 26-year-old male suffering from epigastric pain for several years should emphasize the fact, that even a rare congenital malformation like the annular pancreas must seriously discussed as a reason for the so called unspecific abdominal pain. Embryological development, age of manifestation, symptom...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1990-08-01 00:00:00
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journal_title:Zeitschrift fur Gastroenterologie
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journal_title:Zeitschrift fur Gastroenterologie
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doi:
更新日期:1981-06-01 00:00:00
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journal_title:Zeitschrift fur Gastroenterologie
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doi:
更新日期:1982-09-01 00:00:00
abstract::Plasma secretin and pancreatic polypeptide has been measured in 10 normal volunteers before and after intraduodenal acidification. Secretin rose rapidly from 1,4 +/- 0,44 to 11,2 +/- 1,24 pmol/l (+/- SEM). PP also rose significantly from 39,0 +/- 3,0 to 52.3 +/- 5,8 pmol (paired p less than 0.01) but much slower and t...
journal_title:Zeitschrift fur Gastroenterologie
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doi:
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abstract::Introduction and aims High-resolution esophageal manometry (HRM) has improved the diagnostic work-up of esophageal motility disorders. Simultaneous evaluation of bolus clearance delivers useful information about the function of tubular esophagus. We assessed bolus clearance in a combined HRM-impedance examination for ...
journal_title:Zeitschrift fur Gastroenterologie
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journal_title:Zeitschrift fur Gastroenterologie
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abstract::Patients with hepatocellular carcinoma (HCC) in cirrhosis have an increased risk for postoperative complications including liver failure. However, there is some evidence that the use of laparoscopy markedly decreases this risk. Patients Between 2010 - 2015, a total of 21 laparoscopic liver resections were performed fo...
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pub_type: 杂志文章
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journal_title:Zeitschrift fur Gastroenterologie
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abstract::Potential therapeutic benefits of dietary n-3 fatty acids are presently evaluated in arteriosclerotic and chronic inflammatory diseases. Because some other long-chain fatty acids inhibit intestinal fluid absorption, the effects of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) on fluid and electrolyte tran...
journal_title:Zeitschrift fur Gastroenterologie
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doi:
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