{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:51:44Z","timestamp":1791186704151,"version":"4.1.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Chirurgie"],"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Hintergrund<\/jats:title>\n                    <jats:p>Die laparoskopische Cholezystektomie z\u00e4hlt mit ca. 175.000 Eingriffen\/Jahr (IQTIG, AJ 2024) zu den h\u00e4ufigsten viszeralchirurgischen Eingriffen in Deutschland. Seit 2026 ist die \u201eeinfache\u201c laparoskopische Cholezystektomie (H08M) Teil der sektorengleichen Hybrid-DRG nach \u00a7\u00a0115f\u00a0SGB\u00a0V.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ziel<\/jats:title>\n                    <jats:p>Kritische Analyse der Hybrid-DRG-Zuordnung anhand von Evidenz, Kodier\u2011\/Gruppierungslogik, Versorgungsrealit\u00e4t und \u00f6konomischen Implikationen sowie eine Modellrechnung zur erwarteten Fallverteilung.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ergebnisse<\/jats:title>\n                    <jats:p>Die aktuelle Kontextfaktoren-Logik grenzt Hybrid- und volle station\u00e4re DRG nicht konsistent nach Schweregrad ab: akute Cholezystitis ohne Gallenstein (K81.0) ist Kontextfaktor (station\u00e4re DRG H08C), akute Cholezystitis mit Gallenstein (K80.00\/K80.01) dagegen nicht, obwohl der Behandlungsaufwand vergleichbar oder h\u00f6her ist. Nach Modellrechnung auf Basis der IQTIG-Routinedaten 2022 bis 2024 d\u00fcrften j\u00e4hrlich ca.\u00a093.000 bis 96.000 F\u00e4lle (\u2248\u202f60\u201365\u202f% der \u201eeinfachen\u201c laparoskopischen Cholezystektomien) unkompliziert und damit Hybrid-DRG-f\u00e4hig sein, w\u00e4hrend bei ca.\u00a052.000bis 55.000 F\u00e4llen\/Jahr (\u2248\u202f35\u201338\u202f%) eine akute Cholezystitis vorliegt, deren Zuordnung uneinheitlich und teils unplausibel ist. Der reale ambulante Anteil d\u00fcrfte weiterhin unter 1\u202f% liegen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Schlussfolgerung<\/jats:title>\n                    <jats:p>Hybrid-DRG-F\u00e4higkeit ist nicht mit ambulanter Eignung gleichzusetzen. Erforderlich sind diagnosebezogen pr\u00e4zisierte Kontextfaktoren, eine korrekte, sanktionsfreie Kodierlogik sowie eine leistungsgerechte Abbildung von Vorhaltekosten und Weiterbildung.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00104-026-02593-z","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T06:53:59Z","timestamp":1791183239000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Die \u201eeinfache\u201c laparoskopische Cholezystektomie als Hybrid-DRG 2026","The \u201csimple\u201d laparoscopic cholecystectomy as a\u00a0hybrid DRG in 2026"],"prefix":"10.1007","author":[{"given":"Colin M.","family":"Kr\u00fcger","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Buia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waldemar","family":"Uhl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Bartkowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut","family":"Witzigmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Ulrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Nowak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"2593_CR1","volume-title":"Hybrid-DRG: Spezielle sektorengleiche Verg\u00fctung; Praxisinformation und Verg\u00fctung 2026","author":"Kassen\u00e4rztliche Bundesvereinigung","year":"2026","unstructured":"Kassen\u00e4rztliche Bundesvereinigung (2026) Hybrid-DRG: Spezielle sektorengleiche Verg\u00fctung; Praxisinformation und Verg\u00fctung 2026. KBV, Berlin"},{"key":"2593_CR2","unstructured":"Sozialgesetzbuch V (2026) \u00a7 115f SGB V \u2013 Spezielle sektorengleiche Verg\u00fctung. (Bundesrecht; aktuelle Fassung 2026)"},{"key":"2593_CR3","unstructured":"Schweins M, EM. Outpatient laparoscopic cholecystectomy. 1997."},{"key":"2593_CR4","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006798.pub4","volume":"2013","author":"J Vaughan","year":"2013","unstructured":"Vaughan\u00a0J, Gurusamy\u00a0KS, Davidson\u00a0BR (2013) Day-surgery versus overnight stay surgery for laparoscopic cholecystectomy. Cochrane Database Syst Rev 2013:CD006798. https:\/\/doi.org\/10.1002\/14651858.CD006798.pub4","journal-title":"Cochrane Database Syst Rev"},{"key":"2593_CR5","doi-asserted-by":"publisher","first-page":"4950","DOI":"10.1007\/s00464-017-5610-1","volume":"31","author":"XY Hao","year":"2017","unstructured":"Hao\u00a0XY, Shen\u00a0YF, Wei\u00a0YG, Liu\u00a0F, Li\u00a0HY, Li\u00a0B (2017) Safety and effectiveness of day-surgery laparoscopic cholecystectomy is still uncertain: meta-analysis of eight randomized controlled trials based on GRADE approach. Surg Endosc 31:4950\u20134963. https:\/\/doi.org\/10.1007\/s00464-017-5610-1","journal-title":"Surg Endosc"},{"key":"2593_CR6","doi-asserted-by":"crossref","unstructured":"Robinson TN, Biffl WL, Moore EE, Heimbach JK, Calkins CM, Burch JM. Predicting failure of outpatient laparoscopic cholecystectomy. Am J Surg. 2002.","DOI":"10.1016\/S0002-9610(02)01080-2"},{"key":"2593_CR7","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/j.surg.2020.12.029","volume":"170","author":"I Balciscueta","year":"2021","unstructured":"Balciscueta\u00a0I, Barber\u00e0\u00a0F, Lorenzo\u00a0J, Mart\u00ednez\u00a0S, Sebasti\u00e1n\u00a0M, Balciscueta\u00a0Z (2021) Ambulatory laparoscopic cholecystectomy: Systematic review and meta-analysis of predictors of failure. Surgery 170:373\u2013382. https:\/\/doi.org\/10.1016\/j.surg.2020.12.029","journal-title":"Surgery"},{"key":"2593_CR8","unstructured":"OECD (2026) Health Statistics 2026 \u2013 Surgical Procedures (Laparoscopic Cholecystectomy, Inpatient & Day Cases). https:\/\/data-explorer.oecd.org\/. Zugegriffen: 22. Juli 2026 (Dataset)"},{"issue":"7","key":"2593_CR9","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1007\/s00104-025-02263-6","volume":"96","author":"J Klose","year":"2025","unstructured":"Klose\u00a0J, Rudroff\u00a0C, Fischer\u00a0L, Rebelo\u00a0A, Kleeff\u00a0J, Wilke\u00a0RM (2025) Challenges in outpatient surgical treatment in Germany. Chirurgie 96(7):574\u2013582. https:\/\/doi.org\/10.1007\/s00104-025-02263-6","journal-title":"Chirurgie (Heidelb)"},{"key":"2593_CR10","unstructured":"Erg\u00e4nzter erweiterter Bewertungsausschuss (2025) Beschluss zum Hybrid-DRG-Leistungskatalog 2026 und zur Verg\u00fctung der Hybrid-DRG f\u00fcr das Jahr 2026."},{"key":"2593_CR11","volume-title":"Hybrid-DRG gem\u00e4\u00df \u00a7 115f SGB V: Abrechnung und sektorengleiche Fallpauschalen","author":"GKV-Spitzenverband","year":"2026","unstructured":"GKV-Spitzenverband (2026) Hybrid-DRG gem\u00e4\u00df \u00a7 115f SGB V: Abrechnung und sektorengleiche Fallpauschalen. GKV-Spitzenverband, Berlin"},{"key":"2593_CR12","volume-title":"Zusammengefasste Regelungen zu \u00a7 115f SGB V (Hybrid-DRG) f\u00fcr das Jahr 2026; Kontextfaktoren und Regelungen zur Hybrid-DRG-Verg\u00fctung 2026","author":"Kassen\u00e4rztliche Bundesvereinigung","year":"2026","unstructured":"Kassen\u00e4rztliche Bundesvereinigung (2026) Zusammengefasste Regelungen zu \u00a7 115f SGB V (Hybrid-DRG) f\u00fcr das Jahr 2026; Kontextfaktoren und Regelungen zur Hybrid-DRG-Verg\u00fctung 2026. KBV, Berlin"},{"key":"2593_CR13","volume-title":"Bundesauswertung zum Erfassungsjahr 2023: Cholezystektomie (CHE)","author":"IQTIG \u2013 Institut f\u00fcr Qualit\u00e4tssicherung und Transparenz im Gesundheitswesen","year":"2024","unstructured":"IQTIG \u2013 Institut f\u00fcr Qualit\u00e4tssicherung und Transparenz im Gesundheitswesen (2024) Bundesauswertung zum Erfassungsjahr 2023: Cholezystektomie (CHE). IQTIG, Berlin (erstellt im Auftrag des Gemeinsamen Bundesausschusses)"},{"key":"2593_CR14","unstructured":"Bartkowski R. DRG-Vorschlagsverfahren Nr. 270165: Kontextfaktoren Hybrid-DRG H08M. Deutsche Gesellschaft f\u00fcr Allgemein- und Viszeralchirurgie; 2026."},{"key":"2593_CR15","doi-asserted-by":"publisher","first-page":"69","DOI":"10.2147\/POR.S169255","volume":"9","author":"J Blythe","year":"2018","unstructured":"Blythe\u00a0J, Herrmann\u00a0E, Faust\u00a0D, Falk\u00a0S, Edwards-Lehr\u00a0T, Stockhausen\u00a0F et\u00a0al (2018) Acute cholecystitis \u2013 a\u00a0cohort study in a\u00a0real-world clinical setting (REWO study, NCT02796443). Pragmat Obs Res 9:69\u201375. https:\/\/doi.org\/10.2147\/POR.S169255","journal-title":"Pragmat Obs Res"},{"key":"2593_CR16","unstructured":"Bartkowski R (2026) Anmerkungen zum Paper \u201eEinstufung der laparoskopischen Cholezystektomie als Hybrid-DRG und die Durchf\u00fchrung als ambulante Leistung \u2013 kritisch betrachtet\u201c. (Stellungnahme)"},{"key":"2593_CR17","unstructured":"Deutscher Bundestag (2026) Gesetz zur Stabilisierung der Beitragss\u00e4tze in der gesetzlichen Krankenversicherung (GKV-Beitragssatzstabilisierungsgesetz). (BT-Drucksache 21\/6130)"},{"key":"2593_CR18","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1007\/s00104-024-02167-x","volume":"95","author":"I Photiadis","year":"2024","unstructured":"Photiadis\u00a0I, Eckhardt\u00a0D, Loch\u00a0E, H\u00fcttner\u00a0FJ, Diener\u00a0MK, Heger\u00a0P (2024) Outpatient cholecystectomy as the next step? Discussion and possible criteria in the selection of patients. Chirurgie 95:962\u2013969. https:\/\/doi.org\/10.1007\/s00104-024-02167-x","journal-title":"Chirurgie"}],"container-title":["Die Chirurgie"],"original-title":[],"language":"de","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00104-026-02593-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00104-026-02593-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00104-026-02593-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T06:54:00Z","timestamp":1791183240000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00104-026-02593-z"}},"subtitle":["Kritische Bewertung und Praxisorientierung","Critical appraisal and practical orientation"],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":18,"alternative-id":["2593"],"URL":"https:\/\/doi.org\/10.1007\/s00104-026-02593-z","relation":{},"ISSN":["2731-6971","2731-698X"],"issn-type":[{"value":"2731-6971","type":"print"},{"value":"2731-698X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]},"assertion":[{"value":"19 August 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 August 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 August 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 October 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"C.M.\u00a0Kr\u00fcger, A.\u00a0Buia, W.\u00a0Uhl, R.\u00a0Bartkowski, H.\u00a0Witzigmann, A.\u00a0Ulrich und K.\u00a0Nowak geben an, dass kein Interessenkonflikt besteht.","order":1,"name":"Ethics","label":"Interessenkonflikt","group":{"name":"EthicsHeading","label":"Einhaltung ethischer Richtlinien"}},{"value":"F\u00fcr diesen Beitrag wurden von den Autor\/-innen keine Studien an Menschen oder Tieren durchgef\u00fchrt. F\u00fcr die aufgef\u00fchrten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Einhaltung ethischer Richtlinien"}}]}}