{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:21:03Z","timestamp":1790605263926,"version":"4.1.0"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Geburtshilfe Neonatol"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Hintergrund\u2002 Komplexe Fehlbildungen erfordern eine ressourcenintensive\n                    Versorgung. Verg\u00fctungsmuster der korrektiven Fehlbildungschirurgie wurden vor\n                    dem Hintergrund der Versorgungslandschaft bisher nicht analysiert.<\/jats:p><jats:p>\n          Methoden\u2002 Krankenhausabrechnungsdaten zu Korrekturoperationen von zehn\n                    ausgew\u00e4hlten komplexen Fehlbildungen von 2020\u20132022 wurden analysiert. Nach dem\n                    j\u00e4hrlichen Durchschnitt der Fallzahlen wurden Standorte in\n                    Hochvolumenkrankenh\u00e4user (HVK; mindestens 10 F\u00e4lle), Mittelvolumenkrankenh\u00e4user\n                    (MVK; mindestens 5 aber weniger als 10 F\u00e4lle), Niedrigvolumenkrankenh\u00e4user (NVK;\n                    mindestens 1 aber weniger als 5 F\u00e4lle) und in extreme\n                    Niedrigvolumenkrankenh\u00e4user (eNVK; mehr als 0 aber weniger als 1 Fall)\n                    kategorisiert.<\/jats:p><jats:p>\n          Ergebnisse\u2002 Von 2020\u20132022 wurden j\u00e4hrlich durchschnittlich 1429\n                    Korrekturoperationen f\u00fcr die zehn komplexen Fehlbildungen in Deutschland an 158\n                    Standorten erbracht. Der Case Mix Index (CMI) f\u00fcr diese Leistungen betrug 7,057.\n                    Die Leistungserbringung war dezentral. Es gab vier HVK f\u00fcr anorektale\n                    Malformation, drei HVK f\u00fcr Spina bifida, zwei HVK f\u00fcr kongenitale\n                    Zwerchfellhernie und jeweils eines f\u00fcr Blasenekstrophie, Epispadie,\n                    Gallengangsatresie und Morbus Hirschsprung. Es gab kein HVK f\u00fcr Gastrochisis,\n                    Omphalozele oder \u00d6sophagusatresie. 127 Standorte (80%) erreichten f\u00fcr keine der\n                    Leistungen eine Mindestfallzahl von 5 Korrekturoperationen pro Jahr.<\/jats:p><jats:p>\n          Fazit\u2002 Der CMI der korrektiven Fehlbildungschirurgie ist weit h\u00f6her als\n                    der CMI der allgemeinen \u201eKinder- und Jugendchirurgie\u201c. Die Versorgungslandschaft\n                    ist dezentral. Gelegenheitsversorgung stellt f\u00fcr Krankenhausstandorte ein\n                    finanzielles Risiko dar.<\/jats:p>","DOI":"10.1055\/a-2437-0367","type":"journal-article","created":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:05:23Z","timestamp":1731629123000},"page":"44-52","source":"Crossref","is-referenced-by-count":4,"title":["Strukturelle H\u00fcrden der Verg\u00fctung der kinderchirurgischen Behandlung\n                    komplexer Fehlbildungen im Deutschen G-DRG System"],"prefix":"10.1055","volume":"229","author":[{"given":"Miriam","family":"Wilms","sequence":"additional","affiliation":[{"name":"Allgemein-, Viszeral-, Thorax- und Kinderchirurgie,\n                    Universit\u00e4tsklinikum D\u00fcsseldorf, D\u00fcsseldorf, Germany"},{"name":"Selbsthilfeorganisation f\u00fcr Menschen mit Anorektalen Malformationen und\n                    Morbus Hirschsprung, SoMA e.V., M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horst","family":"Schuster","sequence":"additional","affiliation":[{"name":"GKV-Spitzenverband, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz","family":"Krause","sequence":"additional","affiliation":[{"name":"GKV-Spitzenverband, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Wolff","sequence":"additional","affiliation":[{"name":"GKV-Spitzenverband, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Boettcher","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Kinder- und Jugendchirurgie,\n                    Universit\u00e4tsmedizin Mannheim, Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfram Trudo","family":"Knoefel","sequence":"additional","affiliation":[{"name":"Allgemein-, Viszeral-, Thorax- und Kinderchirurgie,\n                    Universit\u00e4tsklinikum D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5415-8784","authenticated-orcid":false,"given":"Ekkehart","family":"Jenetzky","sequence":"additional","affiliation":[{"name":"Lehrstuhl f\u00fcr Medizintheorie, Integrative und\n                    Anthroposophische Medizin, Universit\u00e4t Witten\/Herdecke, Witten,\n                    Germany"},{"name":"Klinik und Poliklinik f\u00fcr Kinder- und Jugendpsychiatrie\n                    und -psychotherapie, Universit\u00e4tsmedizin der Johannes Gutenberg-Universit\u00e4t\n                    Mainz, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,11,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1159\/000520113","article-title":"Prevalence and Infant Mortality of Major Congenital 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