Background
Methods
Data selection
Code | Bill code description [29] | Procedure [25] | Part of training [45] | |
---|---|---|---|---|
GP | GIM | |||
Well-child visit | ||||
01712 | Well-child visit of the new-born during the 3rd to 10th day of life | Well-child visit | yes | no |
01713 | Well-child visit during the 4th and 5th week of life “(U3)” | |||
01714 | Well-child visit during the 3rd and 4th month of life “(U4)” | |||
01715 | Well-child visit during the 6th and 8th month of life “(U5)” | |||
01716 | Well-child visit during the 10th and 12th month of life “(U6)” | |||
01717 | Well-child visit during the 21st to 24th month of life “(U7)” | |||
01718 | Well-child visit during the 46th to 48th month of life “(U8)” | |||
01719 | Well-child visit during the 60th to 64th month of life “(U9)” | |||
01723 | Well-child visit during the 36th to 43rd month of life “(U7a)” | |||
01720 | Adolescent health examination “(J1)” | Adolescent health examination | yes | no |
Minor surgery | ||||
02301 | Minor surgery II: primary wound closure with sutures | Surgical suture | yes | no |
Drainage of acute paronychia | yes | no | ||
Electrocautery of skin lesion | yes | no | ||
I&D of an abscess | yes | no | ||
I&D of a perianal abscess | yes | no | ||
Glueing of a wound | yes | no | ||
02302 | Minor surgery III: excisions, treatment of ingrown toenails, phlebotomy | Removal of foreign object | yes | no |
Excision of lipoma | yes | no | ||
Partial removal of toenail | yes | no | ||
02310 | Secondary healing wound care and/or decubital ulcer care | Wound debridement | yes | no |
02311 | Diabetic foot care | |||
02312 | Treatment of single or multiple chronic venous ulcers | |||
02313 | Compression therapy for chronic venous insufficiency, post-thrombotic syndrome, superficial and deep vein thrombosis and/or lymphoedema | Compression therapy | no | no |
Injection and infusion | ||||
02101 | Infusion | Infusion | yes | yes |
02321 | Suprapubic catheter insertion | Suprapubic catheter insertion | yes | yes |
02323 | Transurethral catheter insertion | Transurethral catheter insertion | yes | yes |
Paracentesis and insertion | ||||
02340 | Paracentesis | Ascites paracentesis | yes | yes |
Trepination of subungual haematoma | yes | no | ||
Paracentesis of knee joint | yes | yes | ||
Paracentesis of scapula joint | yes | yes | ||
02343 | Trephination of pleural cavity and non-surgical pleural drainage | Thoracentesis | yes | yes |
Trepination of tension pneumothorax | yes | yes | ||
Chest tube insertion | yes | yes | ||
Treatment of musculoskeletal disorders | ||||
02360 | Treatment under local anaesthesia | Neural therapy | yes | no |
31,910 | Reduction of carpal or tarsal dislocation (distal) | Reduction of dislocated finger | noa | no |
31,912 | Reduction of dislocated cubital or knee joint (distal) | Reduction of displaced fracture of the radial head | noa | no |
31,914 | Reduction of dislocated cubital or knee joint (proximal) | Reduction of dislocated shoulder joint | noa | no |
Instrument-based procedures | ||||
02500 | Single inhalation therapy | Preparing a nebulizer for antiobstructive therapy | no | no |
03321 | Cardiac stress test | Cardiac stress test | yes | yes |
03324 | 24-h ambulatory blood pressure monitoring | 24-h ambulatory blood pressure monitoring | yes | yes |
03330 | Spirometry | Spirometry | yes | yes |
03331 | Proctoscopy | Proctoscopy | yes | yes |
03335 | Exploratory audiometry after previously documented, hearing test anomalies | Diagnostic audiometer test | no | no |
33012 | Thyroid sonography B-scan | Thyroid sonography thyroid | yes | yes |
33042 | Abdominal sonography B-scan | Abdominal sonography | yes | yes |
33060 | Sonographic examination of extracranial cerebral vessels, the periorbital arteries, subclavian arteries and vertebral arteries by CW-Doppler | Doppler ultrasound of brain-supplying vessels | yes | yes |
33061 | CW Doppler sonography of limb blood vessels, at least 3 transducer locations per limb | Compression sonography of lower extremities | yes | yes |
33076 | Limb vein B-scan sonography at least 8 transducer locations | |||
Laboratory diagnostic procedures | ||||
32031 | Microscopic urinalysis for morphological components | Microscopic urinalysis | yes | yes |
32040 | Faecal occult blood test in 3 samples | Faecal occult blood test | yes | yes |
01734 | Examination for faecal occult blood according to stage D.-III of the early detection of cancer-guideline, including costs | |||
32045 | microscopic examination of bodily material | Examine a native sample for funghi | yes | yes |
Emergency medicine | ||||
01220 | Resuscitation | Mask ventilation | yes | yes |
01221 | Supplement to Resuscitation (Coniotomy and / or Endotracheal Intubation) | Endotracheal intubation | yes | yes |
01222 | Supplement to Resuscitation (defibrillation) | Defibrillation | yes | yes |
Gynaecology | ||||
01830 | Insertion of intrauterine device | insertion of intrauterine device | no | no |
01730 | Cancer screening for women | Gynaecological examination | no | no |
01825 | Cervical smear test | Cervical smear test | no | no |
Statistical analysis
Results
year | 2013 | 2015 | change (in %) | |||
---|---|---|---|---|---|---|
specialty | GP | GIM | GP | GIM | GP | GIM |
physicians | 1228 | 447 | 1227 | 484 | −0.1 | 8.3 |
number of fee scale codes invoiced | 697 | 613 | 683 | 675 | −2.0 | 10.1 |
total number of codes invoiced by all physicians | 6,752,667 | 2,499,625 | 8,856,848 | 3,442,080 | 31.2 | 37.7 |
total number of codes invoiced per physician | 5498.9 | 5592.0 | 7218.3 | 7111.7 | 31.3 | 27.2 |
total number of codes invoiced by all physicians reflecting selected procedures | 179,095 | 85,413 | 180,779 | 93,286 | 0.9 | 9.2 |
percentage of the total number of codes reflecting selected procedures (in %) | 2.7 | 3.4 | 2.0 | 2.7 | −23.0 | −20.7 |
Code | Description | 2013 | 2015 | ||||
---|---|---|---|---|---|---|---|
GP (n = 1228) | GIM (n = 447) | p-value* | GP (n = 1227) | GIM (n = 484) | p-value* | ||
02310
| Secondary healing wound care and/or decubital ulcer care | 60.4 | 43.6 | < 0.001 | 64.6 | 44.0 | < 0.001 |
02301
| Minor surgery II: primary wound closure with sutures | 39.0 | 13.4 | < 0.001 | 37.8 | 16.7 | < 0.001 |
01734
| Examination for faecal occult blood according to stage D.-III of the early detection of cancer-guideline, including costs | 27.2 | 22.1 | n.s. | 27.9 | 24.8 | n.s. |
01720
| Adolescent health examination “(J1)” | 27.1 | 13.9 | < 0.001 | 25.5 | 9.5 | < 0.001 |
02312
| Treatment of single or multiple chronic venous ulcers | 23.2 | 17.4 | n.s. | 23.5 | 17.8 | n.s. |
01718
| Well-child visit during the 46th to 48th month of life “(U8)” | 13.8 | 2.5 | < 0.001 | 12.2 | 1.2 | < 0.001 |
01719
| Well-child visit during the 60th to 64th month of life “(U9)” | 13.6 | 2.0 | < 0.001 | 13.9 | 1.4 | < 0.001 |
02302
| Minor surgery III: excisions, treatment of ingrown toenails, phlebotomy | 13.0 | 2.0 | < 0.001 | 12.1 | 2.1 | < 0.001 |
01723
| Well-child visit during the 43rd to 36th month of life “(U7a)” | 10.9 | 1.6 | < 0.001 | 11.8 | 1.7 | < 0.001 |
01717
| Well-child visit during the 21st to 24th month of life “(U7)” | 10.6 | 0.9 | < 0.001 | 10.2 | 1.0 | < 0.001 |
01716
| Well-child visit during the 10th and 12th month of life “(U6)” | 10.3 | 1.8 | < 0.001 | 8.6 | 1.2 | < 0.001 |
01715
| Well-child visit during the 6th and 8th month of life “(U5)” | 8.3 | 1.3 | < 0.001 | 8.2 | 1.2 | < 0.001 |
01714
| Well-child visit during the 3rd and 4th month of life “(U4)” | 8.1 | 1.1 | < 0.001 | 7.1 | 1.2 | < 0.001 |
01713
| Well-child visit during the 4th and 5th week of life “(U3)” | 6.4 | 0.9 | < 0.001 | 6.4 | 0.6 | < 0.001 |
02500
| Single inhalation therapy | 5.3 | 2.5 | n.s. | 4.9 | 2.3 | n.s. |
03335
| Exploratory audiometry after previously documented, hearing test anomalies | 3.7 | 1.6 | n.s. | 3.1 | 0.8 | n.s. |
01730
| Cancer screening for women | 3.2 | 0.0 | 0.010 | 1.8 | 0.0 | n.s. |
01712
| Well-child visit of the new-born during the 3rd to 10th day of life | 2.5 | 0.0 | n.s. | 2.4 | 0.2 | n.s. |
Code | Description | 2013 | 2015 | ||||
---|---|---|---|---|---|---|---|
GP (n = 1228) | GIM (n = 447) | p-value* | GP (n = 1227) | GIM (n = 484) | p-value* | ||
03330
| Spirometry | 80.5 | 82.3 | n.s. | 80.1 | 83.7 | n.s. |
03324
| 24-h ambulatory blood pressure monitoring | 72.2 | 82.8 | < 0.001 | 74.2 | 82.9 | 0.011 |
32040
| Faecal occult blood test in 3 samples | 68.5 | 70.0 | n.s. | 66.0 | 66.9 | n.s. |
33042
| Abdominal sonography B-scan | 52.9 | 91.1 | < 0.001 | 51.6 | 89.3 | < 0.001 |
03321
| Cardiac stress test |
45.5
| 79.6 | < 0.001 |
52.6
| 82.4 | < 0.001 |
32031
| Microscopic urinalysis for morphological components | 37.8 | 41.6 | n.s. | 34.5 | 34.9 | n.s. |
33012
| Thyroid sonography B-scan | 21.4 | 73.6 | < 0.001 | 21.5 | 75.4 | < 0.001 |
02313
| Compression therapy for chronic venous insufficiency, post-thrombotic syndrome, superficial and deep vein thrombosis and/or lymphoedema | 15.8 | 16.1 | n.s. | 20.7 | 19.8 | n.s. |
03331
| Proctoscopy | 6.4 | 7.4 | n.s. | 5.2 | 7.2 | n.s. |
02311
| Diabetic foot care | 6.2 | 10.1 | n.s. | 5.5 | 9.9 | n.s. |
33061
| CW Doppler sonography of limb blood vessels, at least 3 transducer locations per limb | 1.6 | 8.5 | < 0.001 | 1.5 | 7.2 | < 0.001 |
33060
| Sonographic examination of extracranial cerebral vessels, the periorbital arteries, subclavian arteries and vertebral arteries by CW-Doppler | 1.1 | 3.6 | 0.036 | 1.1 | 3.3 | n.s. |
01220
| Resuscitation | 0.7 | 1.1 | n.s. | 1.1 | 0.0 | n.s. |
33076
| Limb vein B-scan sonography at least 8 transducer locations | 0.3 | 8.7 | < 0.001 | 0.6 | 9.3 | < 0.001 |