HOSPITAL OUTCOMES RESEARCH IN GERMANY - RESULTS FROM A RETROSPECTIVE SURVEY AMONG SICKNESS FUND BENEFICIARIES

OBJECTIVES. The authors assess the feasibility of using retrospective, indication-specific patient surveys to conduct hospital outcomes rese arch in Germany. Surgical outcome and patient satisfaction were examin ed in patients who underwent common elective surgical procedures. METH ODS. Using the International Classification of Diseases Ninth Revision coding available in the Schwabisch Gmund health insurance data base, all patients for a defined period of time with one of the three follow ing diagnoses were selected and questioned retrospectively using an in dication-specific survey instrument: (1) varicose veins of the lower e xtremity; (2) nasal septum deviation; and (3) inner knee joint damage limited to patients undergoing arthroscopic meniscus repair: Survey co ntent focused on preoperative conditions, pre-and postoperative sympto ms, postoperative complications, the nature and duration of postoperat ive follow-up, and satisfaction with surgical outcome. RESULTS. Signif icant postoperative improvement of preoperative symptoms was found for all three groups. Complete freedom from symptoms was found in 29.7% o f patients treated for varicose veins, 24.1% of patients with meniscus repair, and in only 10.6% of patients with nasal septum deviation. Mu ltivariate analyses indicated that postoperative impairment was the de cisive variable governing patient satisfaction for all three groups. C ONCLUSIONS. The use of retrospective, indication-specific patient surv eys constitutes a time-efficient, cost-effective, and patient-focused option for the systematic acquisition and evaluation of health outcome s in Germany. This methodology holds promise for international and dom estic efforts to demonstrate the consequences of restructuring activit ies in the inpatient sector.