Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Duodenogastric reflux (DRG) was quantified with continuous 24 hour monitoring of gastric pH in 30 patients, 12 of whom underwent operation for repair of an inguinal or femoral hernia used as a control group. The remaining 18 patients with noncomplicated gallstone disease underwent a simple cholecystectomy. Eight weeks after the operation, the tests were repeated. We found that patients with cholelithiasis were accompanied with DGR or alkaline shift more often than the patients in the control group and cholecystectomy decreased the percentage of time that gastric pH was less than two and increased the time at four and six. Although cholecystectomy itself does cause DGR, most patients with DGR may be asymptomatic.
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PMID:A prospective study of the effect of cholecystectomy on duodenogastric reflux in humans using 24 hour gastric hydrogen monitoring. 162 Dec

The DRG system in Germany was introduced to improve and at the same time simplify the reimbursement of costs in German hospitals. Cost effectiveness and economic efficiency were the declared goals. Structural changes and increased competition among different hospitals were the consequences. The effect on the qualitiy of patient care has been discussed with some concern. Furthermore, doubts have been expressed about the correct representation of the various diagnoses and treatments in the coding system and the financial revenue. Inguinal hernia repair serves as an example to illustrate some common problems with the reimbursement in the DRG system. Virtual patients were grouped using a "Web Grouper" and analysed using the cost accounting from the G-DRG-Browser of the InEK. Additionally, the reimbursement for ambulant hernia repair was estimated. The DRG coding did not differentiate the various operative procedures for inguinal hernia repair. They all generated the same revenues. For example, the increased costs for bilateral inguinal hernia repair are not represented in the payment. Furthermore, no difference is made between primary and recurrent inguinal hernia. In the case of a short-term hospital stay, part of the revenue is retained. In the case of ambulatory treatment of inguinal hernia, the reimbursement is by far not a real compensation for the actual costs. The ideal patient in the DRG system suffers from a primary inguinal hernia, undergoes an open hernia repair without mesh, and remains for 2-3 days in hospital. Minimally invasive procedures, repair of bilateral inguinal hernia and ambulant operation are by far less profitable--if at all. The current revenues for inguinal hernia repair require improvement and adjustment to reality in order to accomplish the goals which the DRG system in Germany aims at.
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PMID:[The quality of patient care under the German DRG system using as example the inguinal hernia repair]. 1827 3