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Is treatment of geriatric hip fracture patients cost-covering? Results of a prospective study conducted at a German University Hospital

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Hip fractures have increased medical and socio-economic importance due to demographic transition. Information concerning direct treatment costs and their reimbursement in Germany is lacking.

Materials and methods

Four hundred two hip fracture patients older than 60 years of age were observed prospectively at a German University Hospital. Treatment costs were determined with up to 196 cost factors and compared to the reimbursement. Finally, statistical analysis was performed to identify clinical parameters influencing the cost–reimbursement relation.

Results

Treatment costs were 8853 € (95% CI 8297–9410 €), while reimbursement was 8196 € (95% CI 7707–8772 €), resulting in a deficit of 657 € (95% CI 143–1117 €). Bivariate analysis showed that the cost–reimbursement relation was negatively influenced mainly by higher age, higher ASA score, readmission to the intensive care unit (ICU) and red blood cell transfusion. Adjusted for other parameters, readmission to the ICU was a significant negative predictor (− 2669 €; 95% CI – 4070 to − 1268 €; p < 0.001), while age of 60–75 years was a positive predictor for the cost–reimbursement relation (1373 €; 95% CI 265–2480 €; p = 0.015).

Conclusions

Treatment of geriatric hip fracture patients in a university hospital in Germany does not seem to be cost-covering. Adjustment of the reimbursement for treatment of complex hip fracture patients should be considered.

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Acknowledgements

The authors would like to thank Mr. Gerd Bodenbender for his support in determining the treatment costs.

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Authors and Affiliations

  1. Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Baldingerstrasse, 35043, Marburg, Germany

    Rene Aigner, Juliana Hack, Daphne Eschbach, Steffen Ruchholtz & Benjamin Buecking

  2. Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany

    Richard Dodel

  3. Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany

    Matthias Knobe

Authors
  1. Rene Aigner
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  2. Juliana Hack
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  3. Daphne Eschbach
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  4. Steffen Ruchholtz
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  5. Matthias Knobe
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  6. Richard Dodel
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  7. Benjamin Buecking
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Correspondence to Rene Aigner.

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Aigner, R., Hack, J., Eschbach, D. et al. Is treatment of geriatric hip fracture patients cost-covering? Results of a prospective study conducted at a German University Hospital. Arch Orthop Trauma Surg 138, 331–337 (2018). https://doi.org/10.1007/s00402-017-2844-2

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  • DOI: https://doi.org/10.1007/s00402-017-2844-2

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